| NPI | 1821554049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE B BRUNER Clinical Director 801-636-3036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2019-02-12 |
| Last Update Date | 2022-04-29 |