Individual
TARA LANE CUELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED
Contact information
Practice address
1124 COLLEGE DR, ROCK SPRINGS, WY 82901-5863
(307) 352-6680
Mailing address
1429 CARBON ST., ROCK SPRINGS, WY 82901
(307) 382-6777
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
PPC-310
WY
Other
Enumeration date
12/05/2006
Last updated
07/08/2007
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