| NPI | 1093439655 |
|---|---|
| Doing Business As | BROOKE FANDRICH |
| Entity Type | Organization |
| Authorized Contact | BROOKE DANIELLE FANDRICH Psych Nures Practitioner 307-212-1042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-09-28 |
| Last Update Date | 2024-05-30 |