| NPI | 1043743388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY LYNN MICHAEL Owner 307-267-1681 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WY LCSW-1038) |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2017-04-08 |