Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor |
NPI | 1003481425 |
---|---|
Provider Name | Jenifer Slider |
First Address | Riverton, WY 82501-0156 |
Second Address | Lander, WY 82520-3145 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2021 |
Last Update Date | 26/05/2021 |