Wild Roots Counseling LLC

NPI #1790484889 in Cody, Wyoming

Provider Information

NPI Number: 1790484889
Entity Type: Organization
Organization Name: Wild Roots Counseling LLC
Primary Specialty: Counselor - Mental Health
Enumeration Date: Feb 27, 2023
Last Updated: May 28, 2024

Practice Location

Address: 337 ROBERT ST
City: Cody
State: Wyoming
ZIP Code: 82414-9268
Phone: (307) 899-2492

Authorized Official

Name: JAMAICA SANTOS MOULTON, LPC
Title: OWNER
Phone: (307) 254-5048

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Professional — Professional	101YP2500X
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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