| NPI | 1912251489 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN EUVOYNNE GORDON Director 307-672-6789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2012-11-05 |
| Last Update Date | 2013-01-22 |