NPI | 1578160966 |
---|---|
Entity Type | Organization |
Authorized Contact | SHAINA SMITH Owner/Licensed Psychologist 307-632-7771 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical |
Additional Taxonomies | 103TM1800X Psychologist, Intellectual & Developmental Disabilities |
Enumeration Date | 2020-10-08 |
Last Update Date | 2021-01-08 |