| NPI | 1932458734 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONITA SUE MORISETTE Clinical Director 307-682-3747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WY 386) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WY 516) |
| 1041C0700X Social Worker, Clinical (Licence: WY 462) | |
| 106H00000X Marriage & Family Therapist (Licence: WY 170) | |
| Enumeration Date | 2012-09-07 |
| Last Update Date | 2012-09-07 |