| 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 |
|---|---|
| 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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