Organization
RENEWAL THERAPY OF WY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY ROBERT HUDSON LMFT (OWNER)
(307) 209-4649
Entity
Organization
Contact information
Practice address
201 W LAKEWAY RD STE 902, GILLETTE, WY 82718-6345
(307) 209-4649
(307) 381-0493
Mailing address
201 W LAKEWAY RD STE 902, GILLETTE, WY 82718-6345
(307) 209-4649
(307) 381-0493
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
12/28/2023
Last updated
12/28/2023
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