| NPI | 1780019240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA A. BERRY Owner/Practitioner 307-760-6125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WY 1049) |
| Enumeration Date | 2013-09-03 |
| Last Update Date | 2013-10-21 |