Individual
MISS JENNIE R DEMARCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
123 COLORADO AVE, CASPER, WY 82609-1703
(307) 472-5090
Mailing address
PO BOX 2094, MILLS, WY 82644-2094
(307) 472-5090
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
104647342
WY
Other
Enumeration date
01/13/2011
Last updated
01/13/2011
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