| NPI | 1548656523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY PETRINO Psychologist/Owner 307-460-0781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: WY 505) |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2015-04-07 |