Organization
MIND SPA, PC
Active
Other names
Mind Spa
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHERI JOLENE FLUELLEN PH.D. (CEO)
(307) 509-0772
Entity
Organization
Contact information
Practice address
719 E 17TH ST, CHEYENNE, WY 82001-4711
(307) 509-0772
(307) 426-4133
Mailing address
719 E 17TH ST, CHEYENNE, WY 82001-4711
(307) 509-0772
(307) 426-4133
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
3495
CO
103T00000X
Psychologist
Primary
498
WY
103TC0700X
Clinical Psychologist
3495
CO
103TC0700X
Clinical Psychologist
498
WY
103TC1900X
Counseling Psychologist
3495
CO
103TC1900X
Counseling Psychologist
498
WY
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
498
WY
261QM0850X
Adult Mental Health Clinic/Center
WY498
WY
261QM0855X
Adolescent and Children Mental Health Clinic/Center
WY498
—
Other
Enumeration date
12/07/2010
Last updated
03/09/2015
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