Basic Information
| Provider Information | |||||||||
| NPI: | 1295818870 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WYOMING BEHAVIORAL INSTITUTE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2521 E 15TH ST | ||||||||
| Address2: | |||||||||
| City: | CASPER | ||||||||
| State: | WY | ||||||||
| PostalCode: | 826094126 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3072377444 | ||||||||
| FaxNumber: | 3074722297 | ||||||||
| Practice Location | |||||||||
| Address1: | 518 N US HIGHWAY 14-16 | ||||||||
| Address2: | UNIT D | ||||||||
| City: | GILLETTE | ||||||||
| State: | WY | ||||||||
| PostalCode: | 827163305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3076820442 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/24/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | DOLL | ||||||||
| AuthorizedOfficialFirstName: | REBECCA | ||||||||
| AuthorizedOfficialMiddleName: | JULETTE | ||||||||
| AuthorizedOfficialTitleorPosition: | THERAPIST | ||||||||
| AuthorizedOfficialTelephone: | 3076820442 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | LCSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 283Q00000X | WY | Y | Hospitals | Psychiatric Hospital |
No ID Information.