| NPI | 1154878338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNE HAHN Lpc 307-760-2683 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: WY LPC-733) |
| Additional Taxonomies | 251B00000X Case Management (Licence: WY LPC-733) |
| Enumeration Date | 2016-09-06 |
| Last Update Date | 2016-09-06 |