Prospera Healthcare Wyoming LLC

NPI #1215671185 in Casper, Wyoming

Provider Information

NPI Number: 1215671185
Entity Type: Organization
Organization Name: Prospera Healthcare Wyoming LLC
Primary Specialty: Behavior Analyst
Enumeration Date: Apr 26, 2022
Last Updated: Apr 26, 2022

Practice Location

Address: 312 W 2ND ST # 2037
City: Casper
State: Wyoming
ZIP Code: 82601-2412
Phone: (972) 900-2488

Authorized Official

Name: CHRIS TILLOTSON
Title: CEO
Phone: (972) 900-2488

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Analyst	103K00000X	Primary

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