Organization
I-MEDIATEWYO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK GASKILL MFT (CEO)
(307) 414-0456
Entity
Organization
Contact information
Practice address
520 E 18TH ST, CHEYENNE, WY 82001-4618
(307) 414-0456
Mailing address
5731 COCHISE RD, CHEYENNE, WY 82009-9655
(307) 414-0456
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
PMFT-284
WY
Other
Enumeration date
04/12/2018
Last updated
04/12/2018
About Stedi
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