| NPI | 1912939786 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON JAUSSI Administrator 801-922-9371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 363L00000X Nurse Practitioner | |
| 103T00000X Psychologist | |
| 1041C0700X Social Worker, Clinical | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2021-03-30 |