| 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 |