Individual
TERILYN MAYLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1841 MADORA AVE, DOUGLAS, WY 82633-3057
(307) 358-2846
(307) 358-5329
Mailing address
1841 MADORA AVE, DOUGLAS, WY 82633-3057
(307) 358-2846
(307) 358-5329
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CAP-184
WY
101YA0400X
Addiction (Substance Use Disorder) Counselor
PAT-065
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1225003023
—
WY
05
—
1932229523
—
WY
Enumeration date
01/03/2014
Last updated
03/17/2021
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