Northeast Wyoming Boces

NPI #1275834467 in Gillette, Wyoming

Provider Information

NPI Number: 1275834467
Entity Type: Organization
Organization Name: Northeast Wyoming Boces
Primary Specialty: Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Nov 4, 2010
Last Updated: Nov 4, 2010

Practice Location

Address: 410 N MILLER AVE
City: Gillette
State: Wyoming
ZIP Code: 82716-2929
Phone: (307) 682-0231

Authorized Official

Name: KELLY TONN
Title: PRINCIPAL
Phone: (307) 686-0231

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X
Psychologist - Clinical — Clinical	103TC0700X
Psychiatry & Neurology - Geriatric Psychiatry — Geriatric Psychiatry	2084P0805X
Physical Therapist	225100000X
Occupational Therapist	225X00000X
Speech-Language Pathologist	235Z00000X
Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320600000X	Primary

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