Jenny Davis
Individual provider Active NPI Counselor · Thermopolis, WY
NPI 1699212670 · NPPES record last updated Jan 27, 2017
Key facts
- NPI
- 1699212670
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- PPC-983 (WY)
- Practice address
- 121 S 4TH St
Thermopolis, WY 82443-2634 - Phone
- (307) 864-3138
- Fax
- (307) 864-3139
- NPI assigned
- Jan 27, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PPC-983 | WY | MD | Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | PPC-983 | WY | Yes |
Addresses
Primary practice location
121 S 4TH St
Thermopolis, WY 82443-2634
Mailing address
121 S 4TH St
Thermopolis, WY 82443-2634
Phone (307) 864-3138
Other providers in Thermopolis, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.