Individual
JESSICA M WYLIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L/CASE MANAGER
Contact information
Practice address
1611 W ODELL AVE, CASPER, WY 82604-4777
(307) 797-0060
Mailing address
1611 W ODELL AVE, CASPER, WY 82604-4777
(307) 797-0060
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/27/2014
Last updated
11/18/2024
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