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Organization
MARIPOSA MENTAL HEALTH, LLC
Active
Organization
MARIPOSA MENTAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY BODNER APRN (OWNER)
(617) 312-7737
Entity
Organization
Contact information
Practice address
580 E BROADWAY AVE, JACKSON, WY 83001-8640
(617) 312-7737
Mailing address
3465 N PINES WAY STE 104, WILSON, WY 83014-9129
(617) 312-7737
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
09/19/2023
Last updated
09/19/2023
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