| NPI | 1821767047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLY R LONG Owner/Therapist 801-901-0245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-09-10 |
| Last Update Date | 2021-09-10 |