| NPI | 1982003596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHRINE JEANINE PARNELL Clinical Therapist 801-209-9797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: UT 8397965-3501) |
| Enumeration Date | 2014-08-19 |
| Last Update Date | 2014-08-19 |