| NPI | 1952619397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE DALTON BEALL Director/President 801-897-5474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: UT 270228-2501) |
| Enumeration Date | 2010-09-20 |
| Last Update Date | 2022-08-15 |