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NPI Code Detail

MEDICARE: EMILY MARLENE PYSKA MS

MEDICARE: EMILY MARLENE PYSKA MS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2101Y00000XCounselor

General Provider Information

NPI Number : 1124710439
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY MARLENE PYSKA MS
Provider Business Mailing Address
First Line : 2710 THOMES AVE
Second Line :
City : CHEYENNE
State : WY
Zip : 82001-3029
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2710 THOMES AVE
Second Line :
City : CHEYENNE
State : WY
Zip : 82001-3029
Country : US
Telephone Number : 307-200-7184
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2023
Last Update Date : 05/24/2023

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