| NPI | 1902293939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM TREADWAY Billing Specialist 801-581-8110 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2015-04-16 |
| Last Update Date | 2015-05-01 |