Individual
STACIE RAYL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4602 E 10TH ST, CHEYENNE, WY 82001-6704
(320) 761-9246
Mailing address
4602 E 10TH ST, CHEYENNE, WY 82001-6704
(320) 761-9246
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
251C00000X
—
WY
Enumeration date
03/27/2016
Last updated
05/17/2016
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