Individual
LAUREN BAYER LEONI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
140 E BROADWAY AVE STE B-13, JACKSON, WY 83001-8632
(307) 413-6528
Mailing address
825 HI COUNTRY DR, JACKSON, WY 83001-9442
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
PPC-874
WY
Other
Enumeration date
06/27/2017
Last updated
06/27/2017
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