Individual
MARY JO JEFFRES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
103 N 5TH ST E, RIVERTON, WY 82501-4402
(307) 463-0890
(307) 463-0891
Mailing address
103 N 5TH ST E, RIVERTON, WY 82501-4402
(307) 463-0890
(307) 463-0891
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
421
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
147314
—
WY
Enumeration date
06/20/2006
Last updated
12/23/2015
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