Individual
AMANDA LYNNE MOREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
612 NORTHVIEW DR, RIVERTON, WY 82501-2628
(307) 330-7812
Mailing address
612 NORTHVIEW DR, RIVERTON, WY 82501-2628
(307) 840-6020
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122219800
—
WY
Enumeration date
05/24/2007
Last updated
12/18/2009
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