Individual
MRS. CALLIE C KIDD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
924 LANE 11, POWELL, WY 82435-9212
(307) 754-2606
Mailing address
924 LANE 11, POWELL, WY 82435-9212
(307) 754-2606
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
08/02/2016
Last updated
08/02/2016
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