| NPI | 1780192252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARI MAGNUSON Counselor 307-331-7787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WY 1447) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WY 1447) |
| 251S00000X (Licence: WY 1447) | |
| Enumeration Date | 2018-01-17 |
| Last Update Date | 2018-01-19 |