| NPI | 1346118106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW PIERCE Authorized Individual 307-683-0983 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2025-10-24 |
| Last Update Date | 2025-10-24 |