| NPI | 1902616717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN PHILLIPS Practice Manager 801-455-9629 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics Developmental - Behavioral Pediatrics |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 235Z00000X Speech-Language Pathologist | |
| 251S00000X Community/Behavioral Health | |
| 103TB0200X Psychologist Cognitive & Behavioral | |
| 103TC0700X Psychologist Clinical | |
| 2084B0040X Psychiatry & Neurology Behavioral Neurology & Neuropsychiatry | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2025-01-13 |
| Last Update Date | 2025-01-13 |