NPI | 1992124473 |
---|---|
Entity Type | Organization |
Authorized Contact | JAQUELINE PACK Owner 801-628-6344 |
Organization Subpart ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 3158913501) |
Enumeration Date | 2014-04-10 |
Last Update Date | 2014-04-10 |