| NPI | 1083937486 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE F. OEDEKOVEN Co Owner 307-686-9422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WY LPC-372) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: WY 540) |
| 101Y00000X Counselor (Licence: WY LPC540) | |
| Enumeration Date | 2010-03-12 |
| Last Update Date | 2010-04-21 |