Organization
LIANE P MCILWAINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LIANE PALISOUL MCILWAINE M.A. (SOLE PROPRIETOR)
(307) 632-8911
Entity
Organization
Contact information
Practice address
3719 DOVER RD, CHEYENNE, WY 82001-1606
(307) 632-8911
(307) 433-0487
Mailing address
3719 DOVER RD, CHEYENNE, WY 82001-1606
(307) 632-8911
(307) 433-0487
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
06/30/2009
Last updated
06/30/2009
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