| NPI | 1972390573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHADIJA TAHIRA EWALT Mental Health Counselor 435-572-0340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2025-04-24 |
| Last Update Date | 2025-05-06 |