| NPI | 1730450032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL ANN BAILEY Agent/Organizer 307-257-1196 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2012-01-18 |
| Last Update Date | 2012-01-18 |