Individual
MARILYN J. KELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3941 HYNDS BLVD, CHEYENNE, WY 82001-1005
(307) 634-6913
Mailing address
3941 HYNDS BLVD, CHEYENNE, WY 82001-1005
(307) 634-6913
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
251C00000X
—
WY
Enumeration date
10/07/2009
Last updated
10/07/2009
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