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Organization

NORTHEAST WYOMING BOCES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KELLY TONN (PRINCIPAL)
(307) 686-0231
Entity
Organization

Contact information

Practice address
410 N MILLER AVE, GILLETTE, WY 82716-2929
(307) 682-0231
Mailing address
410 N MILLER AVE, GILLETTE, WY 82716-2929
(307) 682-0231

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
103TC0700X
Clinical Psychologist
2084P0805X
Geriatric Psychiatry Physician
225100000X
Physical Therapist
225X00000X
Occupational Therapist
235Z00000X
Speech-Language Pathologist
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary

Other

Enumeration date
11/04/2010
Last updated
11/04/2010
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