Organization
HEATHER HAWKINS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER HAWKINS (OWNER)
(307) 640-0772
Entity
Organization
Contact information
Practice address
4322 MIDDLE FORK TRL, CHEYENNE, WY 82007-9378
(307) 640-0772
Mailing address
4322 MIDDLE FORK TRL, CHEYENNE, WY 82007-9378
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
01/05/2015
Last updated
01/05/2015
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