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Organization

SHOSHONE TRIBE EARLY INTERVENTION PROGRAM

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOSEPH J SMITH JR. (FINANCE MANAGER)
(307) 332-3516
Entity
Organization

Contact information

Practice address
90 ETHETE ROAD, FORT WASHAKIE, WY 82514-0610
(307) 332-3516
(307) 332-9116
Mailing address
PO BOX 610, FORT WASHAKIE, WY 82514-0610
(307) 332-3516
(307) 332-9116

Taxonomy

Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
WY

Other

Enumeration date
12/20/2006
Last updated
08/22/2020
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