Travis, Willa J

Travis, Willa J is an sole proprietor health care provider with primary practice located at 10808 Wind Dancer Rd , Cheyenne WY 82009. She recently has 2 registered licenses in different health care specialties including Agencies / Day Training, Developmentally Disabled Services, Other Service Providers / Case Manager/Care Coordinator. Other Service Providers / Case Manager/Care Coordinator is her primary health care specialty. Travis, Willa J can be contacted via phone (307) 514-3679.

Contact Information

Primary practice address
10808 Wind Dancer Rd Cheyenne WY 82009
Phone: (307) 514-3679
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Agencies / Day Training, Developmentally Disabled Services 251C00000X
Other Service Providers / Case Manager/Care Coordinator 171M00000X

Profile Details

NPI number 1568655827
LBN Legal business name Travis, Willa J
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 21st, 2007
Last updated May 14th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568655827 NPPES
Wyoming MEDICAID 1568655827

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