Individual
MELISSA RENVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1534 S WASHINGTON ST, CASPER, WY 82601-3950
(307) 251-9408
Mailing address
1534 S WASHINGTON ST, CASPER, WY 82601-3950
(307) 251-9408
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/22/2023
Last updated
03/22/2023
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