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Individual

JAMAICA SANTOS MOULTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
337 ROBERT ST, CODY, WY 82414-9268
(307) 899-2492
Mailing address
PO BOX 2772, CODY, WY 82414-2772
(307) 899-2492
(307) 578-8130

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
WY-1490
WY
171M00000X
Case Manager/Care Coordinator
PPC-781
WY
172V00000X
Community Health Worker
PPC-781
WY

Other

Enumeration date
09/25/2013
Last updated
05/22/2024
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