Individual
JAQUELINE FALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PEER SUPPORT SPECIAL
Contact information
Practice address
707 SHERIDAN AVE, CODY, WY 82414-3409
(307) 250-7063
Mailing address
707 SHERIDAN AVE, CODY, WY 82414-3409
(307) 250-7063
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
015
WY
Other
Enumeration date
08/26/2021
Last updated
08/26/2021
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