Organization
YOUTH EMERGENCY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANN RENAE PHILLIPS LPC (THERAPIST)
(307) 686-0669
Entity
Organization
Contact information
Practice address
700 LONGMONT ST, GILLETTE, WY 82716-2927
(307) 686-0669
(307) 686-2121
Mailing address
700 LONGMONT ST, GILLETTE, WY 82716-2927
(307) 686-0669
(307) 686-2121
Taxonomy
Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
LPC1150
WY
Other
Enumeration date
04/28/2011
Last updated
04/28/2011
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