| NPI | 1942054036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAREY A LARSON Owner 435-230-3864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103T00000X Psychologist | |
| 106H00000X Marriage & Family Therapist | |
| 225100000X Physical Therapist | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2024-04-15 |
| Last Update Date | 2024-04-15 |