| NPI | 1568706125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSE MAUDE HARRIET Owner 307-217-2161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WY 807) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WY 1139) |
| Enumeration Date | 2012-11-20 |
| Last Update Date | 2012-11-20 |