| NPI | 1992467963 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORY BRAD DENNIS Owner/Operator 801-472-7134 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2021-10-07 |
| Last Update Date | 2023-08-25 |