Teton Wellness Affiliates

NPI #1407480890 in Jackson, Wyoming

Provider Information

NPI Number: 1407480890
Entity Type: Organization
Organization Name: Teton Wellness Affiliates
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Feb 25, 2020
Last Updated: Jun 23, 2020

Practice Location

Address: 125 E PEARL AVE STE B005
City: Jackson
State: Wyoming
ZIP Code: 83001-8599
Phone: (307) 699-5025

Authorized Official

Name: MS. LORRAINE THOMPSON
Title: OWNER
Phone: (307) 699-5025

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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