| NPI | 1902340326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TISA M SUCHER Licensed Clinical Social Worker 307-235-3333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WY 456) |
| Enumeration Date | 2016-12-05 |
| Last Update Date | 2016-12-05 |