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Organization
SHERIDAN PEAK WELLNESS
Active
Organization
SHERIDAN PEAK WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS JENNIFER LEE CLARK R.D. (CORPORATION OWNER)
(307) 683-6874
Entity
Organization
Contact information
Practice address
740 S. THURMOND ST., SHERIDAN, WY 82801
(307) 683-6874
(415) 559-4790
Mailing address
740 S. THURMOND ST., SHERIDAN, WY 82801
(307) 683-6874
(415) 559-4790
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
—
—
133V00000X
Registered Dietitian
Primary
232
WY
133VN1004X
Pediatric Nutrition Registered Dietitian
—
—
133VN1006X
Metabolic Nutrition Registered Dietitian
—
—
Other
Enumeration date
06/20/2018
Last updated
06/20/2018
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