| T&t Rising Phoenix Llc | |
|
1103 Old Town Ln Cheyenne WY 82009-4353 | |
| (307) 426-4855 | |
| (307) 426-4865 |
| Full Name | T&t Rising Phoenix Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1103 Old Town Ln, Cheyenne, Wyoming |
| Authorized Official Name and Position | Alexandra Kane (CLINICAL DIRECTOR) |
| Authorized Official Contact | 3074264855 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| T&t Rising Phoenix Llc 1103 Old Town Ln Cheyenne WY 82009-4353 Ph: (307) 426-4855 | T&t Rising Phoenix Llc 1103 Old Town Ln Cheyenne WY 82009-4353 Ph: (307) 426-4855 |
| NPI Number | 1134830268 |
|---|---|
| Provider Enumeration Date | 12/09/2022 |
| Last Update Date | 08/05/2025 |
| Certification Date | 08/05/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134830268 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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