| NPI | 1831760172 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMANDRA EVETTE FAWSON Managing Member 435-669-7419 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2021-07-08 |
| Last Update Date | 2021-07-08 |