| Independent | |
|
110 Montalto Dr Unit D Cheyenne WY 82007-6514 | |
| (307) 287-6110 | |
| Not Available |
| Full Name | Independent |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 110 Montalto Dr Unit D, Cheyenne, Wyoming |
| Authorized Official Name and Position | Aubri Monique Vahai (FAMILY SUPPORT PARTNER) |
| Authorized Official Contact | 3072876110 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Independent 110 Montalto Dr.unit D Cheyenne WY 82007-6514 Ph: (307) 287-6110 | Independent 110 Montalto Dr Unit D Cheyenne WY 82007-6514 Ph: (307) 287-6110 |
| NPI Number | 1629448790 |
|---|---|
| Provider Enumeration Date | 10/01/2015 |
| Last Update Date | 02/19/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629448790 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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