Individual
MISS FAITH FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2632 FOOTHILL BLVD, ROCK SPRINGS, WY 82901-4756
(307) 212-3284
Mailing address
2632 FOOTHILL BLVD, ROCK SPRINGS, WY 82901-4756
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-176255
WY
Other
Enumeration date
07/16/2021
Last updated
07/16/2021
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