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Individual

MRS. CATHERINE MARSHALL BALLARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4424 COMANCHE DR, LARAMIE, WY 82072-7205
(307) 399-9153
Mailing address
4424 COMANCHE DR, LARAMIE, WY 82072-7205
(307) 399-9153

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
251C00000X
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
251C00000X
WY
Enumeration date
10/01/2010
Last updated
10/01/2010
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