| NPI | 1821520826 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE VICKERMAN GALLIHER Psychologist 435-770-1510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 5074236-2501) |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2017-05-12 |