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Individual

KELSEE JO FICKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
350 CITY VIEW DR STE 206, EVANSTON, WY 82930-5326
(307) 789-7915
(307) 789-6009
Mailing address
492 MILLER AVE, EVANSTON, WY 82930-4922
(307) 677-3369

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
PAT100
WY
171M00000X
Case Manager/Care Coordinator
WY

Other

Enumeration date
09/25/2018
Last updated
05/14/2025
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