Individual
JENA COWEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5305 COWEN DRIVE, GILLETTE, WY 82718
(307) 299-0567
Mailing address
PO BOX 3365, GILLETTE, WY 82717-3365
(307) 299-0567
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
82-2756226
—
WY
Enumeration date
02/26/2015
Last updated
02/08/2019
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