Individual
JACLYN VOOGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
603 E CARLSON ST STE 304, CHEYENNE, WY 82009-4443
(307) 514-9999
(307) 514-6006
Mailing address
1406 W MAIN ST, RIVERTON, WY 82501-3239
(307) 463-0462
(307) 463-2010
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-1447
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154258300
—
WY
Enumeration date
05/05/2017
Last updated
09/30/2021
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