Individual
MARISSA WIDIKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1010 E 1ST ST STE A, CASPER, WY 82601-2753
(307) 234-9979
Mailing address
PO BOX 34, GLENROCK, WY 82637-0034
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
PPC-1619
WY
Other
Enumeration date
01/13/2026
Last updated
01/22/2026
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