Organization
SHOSHONE TRIBE EARLY INTERVENTION PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BARBARA LOCKE (DIRECTOR)
30733223516
Entity
Organization
Contact information
Practice address
90 ETHETE ROAD, FT. WASHAKIE, WY 82514
(307) 332-3516
Mailing address
PO BOX 610, FORT WASHAKIE, WY 82514-0610
(307) 332-3516
(307) 332-9116
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
WY
Other
Enumeration date
12/20/2006
Last updated
08/22/2020
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