| NPI | 1043529662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LELAND BOYD KORB Member 307-436-9304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WY LPC-391) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WY LAT-291) |
| 103TC0700X Psychologist, Clinical | |
| Enumeration Date | 2010-09-30 |
| Last Update Date | 2013-04-11 |