| NPI | 1700665577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTA L BLOUGH Owner 307-395-7510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 364SP0808X Clinical Nurse Specialist, Psych/Mental Health | |
| Enumeration Date | 2023-09-21 |
| Last Update Date | 2024-01-11 |