Individual
MISS LILA FAYE JOLLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.A.
Contact information
Practice address
1106 JULIE LN, POWELL, WY 82435-1632
(307) 271-7460
Mailing address
1106 JULIE LN, POWELL, WY 82435-1632
(307) 271-7460
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/28/2011
Last updated
06/28/2011
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