| Kelly Petrino, Psyd | |
|
507 S 4th St Laramie WY 82070-3753 | |
| (307) 460-0781 | |
| (307) 742-4089 |
| Full Name | Kelly Petrino, Psyd |
|---|---|
| Speciality | Psychologist - Counseling |
| Location | 507 S 4th St, Laramie, Wyoming |
| Authorized Official Name and Position | Kelly Petrino (PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 3074600781 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly Petrino, Psyd 507 S 4th St Laramie WY 82070-3753 Ph: (307) 460-0781 | Kelly Petrino, Psyd 507 S 4th St Laramie WY 82070-3753 Ph: (307) 460-0781 |
| NPI Number | 1548656523 |
|---|---|
| Provider Enumeration Date | 04/07/2015 |
| Last Update Date | 04/07/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548656523 | NPI | - | NPPES |
| 151943 | Medicaid | WY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | 505 (Wyoming) | Primary |
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