Individual
JACQUELYN RALPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PPC
Contact information
Practice address
1575 N 4TH ST STE 103, LARAMIE, WY 82072-2091
(307) 721-0700
Mailing address
1575 N 4TH ST STE 103, LARAMIE, WY 82072-2091
(307) 721-0700
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
PPC-1254
WY
Other
Enumeration date
05/23/2018
Last updated
06/06/2021
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