Individual
TEHLA MARIE BATES STAYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3406 E PERSHING BLVD, CHEYENNE, WY 82001-5916
(307) 421-2465
Mailing address
3406 E PERSHING BLVD, CHEYENNE, WY 82001-5916
(307) 421-2465
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
WY
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
03/25/2016
Last updated
12/29/2020
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