| NPI | 1881043487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN AHERN Clinical Psychologist 801-934-3373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2016-06-06 |