Individual
MR. JERRY TYRONE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PLPC
Contact information
Practice address
6818 PASADENA RD, CHEYENNE, WY 82009-2812
(814) 282-4045
Mailing address
6818 PASADENA RD, CHEYENNE, WY 82009-2812
(814) 282-4045
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1154
WY
Other
Enumeration date
06/02/2020
Last updated
06/02/2020
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