Individual
MS. BERTHA LEE ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
822 RODEO AVE, CHEYENNE, WY 82009-1041
(307) 637-8792
Mailing address
822 RODEO AVE, CHEYENNE, WY 82009-1041
(307) 637-8792
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
Other
Enumeration date
07/21/2009
Last updated
07/21/2009
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