| NPI | 1952814931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESIREE L PORTER Owner 801-499-7869 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: UT 6822650-6004) |
| Enumeration Date | 2017-11-13 |
| Last Update Date | 2021-12-17 |