| NPI | 1659132264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABIGAIL LANE Owner 307-214-0229 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2024-01-22 |
| Last Update Date | 2024-01-22 |