Individual
ELENA MADERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
721 W MAPLE ST, RAWLINS, WY 82301-5447
(307) 324-7156
(307) 328-1651
Mailing address
PO BOX 1056, RAWLINS, WY 82301-1056
(307) 324-7156
(307) 328-1651
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
PPC-1287
WY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/22/2020
Last updated
09/12/2022
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