Renewal Therapy of Wy, LLC

NPI #1720857030 in Gillette, Wyoming

Provider Information

NPI Number: 1720857030
Entity Type: Organization
Organization Name: Renewal Therapy of Wy, LLC
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Dec 28, 2023
Last Updated: Dec 28, 2023

Practice Location

Address: 201 W LAKEWAY RD STE 902
City: Gillette
State: Wyoming
ZIP Code: 82718-6345
Phone: (307) 209-4649

Authorized Official

Name: BRADLEY ROBERT HUDSON, LMFT
Title: OWNER
Phone: (307) 209-4649

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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