Individual
MS. JENNA DANIELLE GALLEGOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
503 S 18TH ST, LARAMIE, WY 82070-4303
(307) 742-3728
Mailing address
1416 E CUSTER ST, APPARTMENT A, LARAMIE, WY 82070-4132
(307) 421-3172
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
739
WY
Other
Enumeration date
09/04/2009
Last updated
09/04/2009
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