Individual
DIONIS RISTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
640 E BROADWAY AVE, JACKSON, WY 83001-8642
(307) 733-2046
(307) 733-6289
Mailing address
PO BOX 11390, JACKSON, WY 83002-1390
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-1635
WY
Other
Enumeration date
12/28/2017
Last updated
02/12/2024
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