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Organization
NORTHEAST WYOMING BOCES
Active
Organization
NORTHEAST WYOMING BOCES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY TONN (PRINCIPAL)
(307) 686-0231
Entity
Organization
Contact information
Practice address
410 N MILLER AVE, GILLETTE, WY 82716-2929
(307) 682-0231
Mailing address
410 N MILLER AVE, GILLETTE, WY 82716-2929
(307) 682-0231
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103TC0700X
Clinical Psychologist
—
—
2084P0805X
Geriatric Psychiatry Physician
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/04/2010
Last updated
11/04/2010
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