| NPI | 1912179144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN MCCABE Owner 307-760-0510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WY 22093.0307) |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2008-03-27 |