| Brain Advancement Center, Llc | |
|
2005 Warren Ave. Cheyenne WY 82001 | |
| (307) 274-4749 | |
| (307) 274-4749 |
| Full Name | Brain Advancement Center, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2005 Warren Ave., Cheyenne, Wyoming |
| Authorized Official Name and Position | Tammi R. Miller (OWNER) |
| Authorized Official Contact | 3072744749 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brain Advancement Center, Llc 2005 Warren Ave Cheyenne WY 82001 Ph: (307) 274-4749 | Brain Advancement Center, Llc 2005 Warren Ave. Cheyenne WY 82001 Ph: (307) 274-4749 |
| NPI Number | 1194382150 |
|---|---|
| Provider Enumeration Date | 05/24/2019 |
| Last Update Date | 10/27/2020 |
| Certification Date | 10/27/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194382150 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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