Doctor Name: | MELODY GRIEBEL |
NPI Number: | 1073969374 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA LPC |
License Number: | 1166 |
Business Practice Address: | 3026 Hardpan Ave., Unit A Cody, WY - 82414 |
Business Phone Number: | 3072160228 |
Business Fax Number: | |
Mailing Address: | 3026 Hardpan Ave., Unit A, CODY |
State: | WY |
Postal Code: | 82414 |
Phone Number: | 3072160228 |
Fax Number: | |
NPI Enumeration Date: | 05/05/2016 |
NPI Last Update Date: | 05/05/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 1166 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |