| NPI | 1194899443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY JOHNSON Owner 307-742-1270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WY LAT 237) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WY LPC 447) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2020-08-22 |