| NPI | 1104275353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNFER LYNN GREENUP Owner 307-247-3901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WY 609) |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2016-06-08 |