| NPI | 1316458540 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEE MICKELSON Owner/Therapist 307-272-3515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WY LCSW-820) |
| Enumeration Date | 2017-10-15 |
| Last Update Date | 2017-10-15 |