| NPI | 1942746060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATT LARSON Lcsw/Owner 801-599-6396 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 9190801-3501) |
| Enumeration Date | 2017-01-12 |
| Last Update Date | 2017-01-12 |