Individual
KRISTY WILMARTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3339 GROVE DR, CHEYENNE, WY 82001-1755
(254) 383-4338
Mailing address
3339 GROVE DR, CHEYENNE, WY 82001-1755
(254) 383-4338
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
Other
Enumeration date
12/29/2016
Last updated
10/13/2018
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