Individual
MIRANDA RACHELLE HACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2301 CRESTVIEW DR, TORRINGTON, WY 82240-2621
(307) 575-1172
Mailing address
1601 E F ST LOT 78, TORRINGTON, WY 82240-2967
(307) 575-1172
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/07/2011
Last updated
10/29/2012
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