| NPI | 1396162046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY ANN FAILES Owner/Clinical Therapist 307-262-2787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WY LPC 732) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WY LAT 269) |
| 101YM0800X Counselor, Mental Health (Licence: WY LPC 732) | |
| 251S00000X Community/Behavioral Health (Licence: WY LPC 732) | |
| 251S00000X Community/Behavioral Health (Licence: WY LAT 269) | |
| Enumeration Date | 2014-03-19 |
| Last Update Date | 2014-03-19 |