| NPI | 1912788423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSANA KINIKINI Fnp/Pmhnp 801-618-7370 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2023-10-10 |
| Last Update Date | 2024-07-15 |