Individual
JESSICA MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
407 W 27TH AVE, TORRINGTON, WY 82240-1839
(307) 338-8099
Mailing address
407 W 27TH AVE, TORRINGTON, WY 82240-1839
(307) 338-8099
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
12009
NE
101Y00000X
Counselor
Primary
1328
WY
Other
Enumeration date
04/18/2023
Last updated
05/02/2023
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