| NPI | 1083036826 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNDEE BARRETT Office Manager 307-358-3056 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WY 413) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WY 290) |
| Enumeration Date | 2014-01-14 |
| Last Update Date | 2014-03-11 |