Individual
IDEL ENRIQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
420 W PEARL AVE FL 2, JACKSON, WY 83001-8409
(307) 734-6040
(307) 460-7343
Mailing address
6930 COLUMBIA RIVER RD, CASPER, WY 82604-5462
(307) 462-9802
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
PPC-1551
WY
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/04/2024
Last updated
06/19/2025
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