| NPI | 1750626123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY LYNNE PENDLEY Director 307-742-6898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WY PPC-587) |
| Enumeration Date | 2012-12-11 |
| Last Update Date | 2012-12-11 |