| NPI | 1881948800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL S COSSABOON Director 307-250-7527 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WY 440) |
| Enumeration Date | 2012-10-29 |
| Last Update Date | 2012-10-29 |