| Organization Name: | ST. GEORGE CHILDREN & FAMILY PSYCHIATRIC CENTER PC |
| NPI Number: | 1225326044 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CANTRIL NIELSEN (OWNER) |
| Mailing Address: | 230 N 1680 E Ste H1 Saint George |
| State: | UT US |
| Postal Code: | 847902584 |
| Phone Number: | 4356521897 |
| Fax Number: | 4356525909 |
| NPI Enumeration Date: | 07/13/2011 |
| NPI Last Update Date: | 09/02/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SP0810X |
| License Number: | 68747874408 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | UT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Psych/Mental Health, Child & Family |
| Taxonomy Definition: | |