| NPI | 1649795907 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE REYNOLDS Clinical Psychologist 307-347-2717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WY 497) |
| Enumeration Date | 2017-08-08 |
| Last Update Date | 2022-07-21 |