Organization
MAGELLAN HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JUDITH ANN PREWITT M. ED (DIRCTOR)
(307) 265-8298
Entity
Organization
Contact information
Practice address
435 NEVADA AVE APT 11, LOVELL, WY 82431-1945
(307) 272-7033
Mailing address
435 NEVADA AVE APT 11, LOVELL, WY 82431-1945
(307) 272-7033
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245605344
—
WY
Enumeration date
09/17/2019
Last updated
09/17/2019
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