NPI | 1831680636 |
---|---|
Entity Type | Organization |
Authorized Contact | LAUREN ALINE GRAHAM Owner 307-250-0645 |
Organization Subpart ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WY LCSW-838) |
Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WY LCSW-838) |
Enumeration Date | 2018-05-29 |
Last Update Date | 2018-05-29 |