Individual
MRS. JENNIFER SUZANNE KNOWLTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LAT
Contact information
Practice address
383 N MAIN ST, 2ND FLOOR, THAYNE, WY 83127
(307) 264-5782
(307) 883-5782
Mailing address
PO BOX 976, THAYNE, WY 83127-0976
(307) 264-5782
(307) 883-5782
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LAT-351
WY
101YA0400X
Addiction (Substance Use Disorder) Counselor
PAT-058
WY
101YP2500X
Professional Counselor
Primary
LPC 1527
WY
101YP2500X
Professional Counselor
PPC-823
WY
172V00000X
Community Health Worker
—
WY
172V00000X
Community Health Worker
—
—
Other
Enumeration date
08/10/2011
Last updated
01/13/2017
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