Individual
MS. JILL ELAINE KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MCSD
Contact information
Practice address
558 EAST 2ND STREET, POWELL, WY 82435
(307) 754-2864
(307) 754-9829
Mailing address
1719 SALSBURY AVE, CODY, WY 82414
(307) 587-5772
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770688871
—
WY
Enumeration date
08/10/2007
Last updated
08/10/2007
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