Individual
REYES PACHECO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PCSW
Contact information
Practice address
1514 E 12TH ST UNIT 201, CASPER, WY 82601-4080
(307) 258-1226
Mailing address
1221 IVY LN, CASPER, WY 82609-3065
(307) 258-1226
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
PCSW
WY
Other
Enumeration date
01/31/2024
Last updated
01/31/2024
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