| Brio & Balance Llc | |
|
440 Nevada Ave Lovell WY 82431-1916 | |
| (307) 754-7105 | |
| (307) 548-2341 |
| Full Name | Brio & Balance Llc |
|---|---|
| Speciality | Counselor |
| Location | 440 Nevada Ave, Lovell, Wyoming |
| Authorized Official Name and Position | Jessica J Rapp (OWNER/PRESIDENT) |
| Authorized Official Contact | 3077547105 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brio & Balance Llc Po Box 1330 Powell WY 82435-1330 Ph: (307) 754-3319 | Brio & Balance Llc 440 Nevada Ave Lovell WY 82431-1916 Ph: (307) 754-7105 |
| NPI Number | 1306322524 |
|---|---|
| Provider Enumeration Date | 07/11/2018 |
| Last Update Date | 07/11/2018 |
| Medicare PECOS PAC ID | 9133463680 |
|---|---|
| Medicare Enrollment ID | O20181210003404 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306322524 | NPI | - | NPPES |
| LPC-1452 | Other | WY | WY LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LPC-1452 (Wyoming) | Primary |
| Provider Name | Marlynn Riker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104070069 PECOS PAC ID: 5092093013 Enrollment ID: I20161026001841 |
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