Individual
EKATERINA DMITRENOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
249 BONNEVILLE RD # 7609, STAR VALLEY RANCH, WY 83127-5207
(619) 944-1612
Mailing address
249 BONNEVILLE RD # 7609, STAR VALLEY RANCH, WY 83127-5207
(619) 944-1612
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
—
—
Other
Enumeration date
06/11/2024
Last updated
06/11/2024
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