Individual
GISSEL BERNARD-MOLINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PPC
Contact information
Practice address
504 E LYON ST, LARAMIE, WY 82072-2132
(307) 223-2172
Mailing address
2737 NIGHTHAWK DR, LARAMIE, WY 82072-1992
(307) 223-2172
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
PPC-1320
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PPC-1320
STATE LICENSE
WY
Enumeration date
10/10/2024
Last updated
10/10/2024
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