| NPI | 1821395633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN GAWRYS Administrator 801-822-4892 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: UT 53747966004) |
| Enumeration Date | 2011-02-15 |
| Last Update Date | 2011-02-15 |