I-Mediatewyo LLC

NPI #1962909127 in Cheyenne, Wyoming

Provider Information

NPI Number
1962909127
Entity Type
Organization
Organization Name
I-Mediatewyo LLC
Primary Specialty
Marriage & Family Therapist
Enumeration Date
Apr 12, 2018
Last Updated
Apr 12, 2018

Practice Location

Address
520 E 18TH ST
State
Wyoming
ZIP Code
82001-4618
Phone
(307) 414-0456

Authorized Official

Name
MARK GASKILL, MFT
Title
CEO
Phone
(307) 414-0456

Specialties & Taxonomy Codes

Specialty
Marriage & Family Therapist

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