| NPI | 1184456626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYLA RILEY Owner 307-689-2954 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2024-08-14 |
| Last Update Date | 2024-08-14 |