The Olive Branch, Llc | |
1603 Capitol Ave Ste 303c Cheyenne WY 82001-4561 | |
(910) 849-5517 | |
Not Available |
Full Name | The Olive Branch, Llc |
---|---|
Speciality | Behavior Analyst |
Location | 1603 Capitol Ave Ste 303c, Cheyenne, Wyoming |
Authorized Official Name and Position | Tera Campbell (OWNER) |
Authorized Official Contact | 9108495517 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
The Olive Branch, Llc 1603 Capitol Ave Ste 303c Cheyenne WY 82001-4561 Ph: () - | The Olive Branch, Llc 1603 Capitol Ave Ste 303c Cheyenne WY 82001-4561 Ph: (910) 849-5517 |
NPI Number | 1114405875 |
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Provider Enumeration Date | 08/03/2018 |
Last Update Date | 08/03/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1114405875 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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