| NPI | 1962948059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLI BEALL Office Manager 801-263-6367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: UT 30465) |
| Enumeration Date | 2017-01-12 |
| Last Update Date | 2017-01-12 |