| NPI | 1295211787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE RUE Psychologist 307-690-2763 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WY 656) |
| Enumeration Date | 2018-07-17 |
| Last Update Date | 2018-07-17 |