IDEL ENRIQUEZ
Individual Provider (NPI-1)
Active
Counselor, Mental Health
Provider Information
- NPI Number
1902612070- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 420 W PEARL AVE FL 2, JACKSON, WY, 830018409
- Phone
- (307) 734-6040
- Fax
- (307) 460-7343
Specialties & Taxonomies
Counselor, Mental Health
License: WY #PPC-1551
Counselor, Mental Health
Primary