| NPI | 1972082527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MASHELLE BOSWELL Owner 435-770-7813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 276083-3501) |
| Enumeration Date | 2018-08-13 |
| Last Update Date | 2018-08-13 |