| NPI | 1588960108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT BAYUK Psychologist 307-347-8411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: WY 139) |
| Enumeration Date | 2011-01-28 |
| Last Update Date | 2014-10-02 |