Organization
SWEETWATER THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER K VINCENT (OWNER)
(307) 840-4576
Entity
Organization
Contact information
Practice address
313 N 5TH ST E, RIVERTON, WY 82501-3612
(307) 840-4576
(307) 463-2578
Mailing address
313 N 5TH ST E, RIVERTON, WY 82501-3612
(307) 840-4576
(307) 463-2578
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
09/11/2009
Last updated
07/16/2012
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