| NPI | 1871029934 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN JACOBS Owner 801-502-4650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: UT 190584-4405-20151209) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2017-05-11 |