Individual
JODI GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
902 N 8TH ST W, RIVERTON, WY 82501-2332
(307) 463-4242
Mailing address
119 S MAIN ST, PAVILLION, WY 82523-9004
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
WY
Other
Enumeration date
09/09/2025
Last updated
09/09/2025
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