Individual
MIRIAH JENELLE BRONDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PPC
Contact information
Practice address
1904 WARREN AVE, CHEYENNE, WY 82001-3730
(307) 317-0973
(307) 216-4318
Mailing address
1455 SILVER FOX LN, CHEYENNE, WY 82009-1071
(913) 274-6073
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
PPC-1478
WY
Other
Enumeration date
07/17/2024
Last updated
07/17/2024
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