Jaqueline Fales, PEER SUPPORT SPECIAL

NPI #1962179903 in Cody, Wyoming

Provider Information

NPI Number: 1962179903
Entity Type: Individual
Name: Jaqueline Fales, PEER SUPPORT SPECIAL
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Peer Specialist
Credential: PEER SUPPORT SPECIAL
Enumeration Date: Aug 26, 2021
Last Updated: Aug 26, 2021

Practice Location

Address: 707 SHERIDAN AVE
City: Cody
State: Wyoming
ZIP Code: 82414-3409
Phone: (307) 250-7063

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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