| NPI | 1982120507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY EILEEN LEHMAN Sole Provider 801-201-7661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 57258483501) |
| Enumeration Date | 2017-08-15 |
| Last Update Date | 2019-03-18 |