| NPI | 1902296148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EIKO MADSEN Secretary 801-885-6354 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 323661-3501) |
| Enumeration Date | 2015-01-26 |
| Last Update Date | 2015-01-26 |