Graduated: 2000
NPI: 1699868950
Practice Locations (2)
SUCCESSOR HEALTHCARE LLC
451 E BISHOP FEDERAL LN
SALT LAKE CITY, UT 841152357
8014877557
UNIVERSITY OF UTAH BEHAVIORAL HEALTH SERVICES
501 S CHIPETA WAY
SALT LAKE CITY, UT 841081222
8015851575
Source: CMS National Downloadable File, September 2026.