| NPI | 1639701899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE LEE HIPSAK Owner/Provider 307-337-1173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2020-02-06 |
| Last Update Date | 2020-02-06 |