Individual
MRS. KERENA LUANN JACQUOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
68 FIVE FINGER PEAKS RD, GILLETTE, WY 82716-9196
(307) 660-2134
Mailing address
68 FIVE FINGER PEAKS RD, GILLETTE, WY 82716-9196
(307) 660-2134
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/21/2018
Last updated
06/21/2018
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