| NPI | 1699902072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA C PELDO Owner 307-751-7900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WY LMFT-096) |
| Enumeration Date | 2009-06-12 |
| Last Update Date | 2009-06-12 |