Individual
JILLIAN K HALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1382 RIVERBEND DR, DOUGLAS, WY 82633-2042
(307) 351-6673
Mailing address
1382 RIVERBEND DR, DOUGLAS, WY 82633-2042
(307) 351-6673
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
172V00000X
Community Health Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1225003023
—
WY
05
—
1932229523
—
WY
Enumeration date
04/29/2010
Last updated
01/22/2025
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