Individual
ALICIA MARIE PERLENFEIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
905 N GURLEY AVE, GILLETTE, WY 82716-2109
(307) 686-0669
Mailing address
4 EL CAMINO CT, GILLETTE, WY 82716
(307) 660-3427
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336393834
—
WY
Enumeration date
05/18/2015
Last updated
06/14/2017
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