Independent

NPI #1629448790 in Cheyenne, Wyoming

Provider Information

NPI Number
1629448790
Entity Type
Organization
Organization Name
Independent
Primary Specialty
Community/Behavioral Health
Enumeration Date
Oct 1, 2015
Last Updated
Feb 19, 2016

Practice Location

Address
110 MONTALTO DR UNIT D
State
Wyoming
ZIP Code
82007-6514
Phone
(307) 287-6110

Authorized Official

Name
AUBRI MONIQUE VAHAI
Title
FAMILY SUPPORT PARTNER
Phone
(307) 287-6110

Specialties & Taxonomy Codes

Specialty
Community/Behavioral Health

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