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Organization

TETON WELLNESS AFFILIATES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LORRAINE THOMPSON (OWNER)
(307) 699-5025
Entity
Organization

Contact information

Practice address
125 E PEARL AVE STE B005, JACKSON, WY 83001-8599
(307) 699-5025
Mailing address
PO BOX 2019, JACKSON, WY 83001-2019
(307) 699-5025

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Enumeration date
02/25/2020
Last updated
06/23/2020
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