Organization
POWDER RIVER BEHAVIOR CONSULTATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRISTINA MARIE LESLIE LMFT, BCBA (OWNER)
(949) 922-3043
Entity
Organization
Contact information
Practice address
812 GLACIER ST, GILLETTE, WY 82718-5752
(949) 922-3043
Mailing address
812 GLACIER ST, GILLETTE, WY 82718-5752
(949) 922-3043
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-13-13894
CO
Other
Enumeration date
05/04/2015
Last updated
05/04/2015
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