Individual
NINA MCCOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
204 W 12TH ST, GILLETTE, WY 82716-4766
(760) 920-8297
Mailing address
204 W 12TH ST, GILLETTE, WY 82716-4766
(760) 920-8297
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/05/2022
Last updated
10/05/2022
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