| NPI | 1235683301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE KOSTREY Sole Managing Member 307-772-1734 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WY 1542) |
| Enumeration Date | 2016-08-06 |
| Last Update Date | 2016-08-12 |