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NPI Code Detail

MEDICARE: LENKA CERVENANOVA

MEDICARE: LENKA CERVENANOVA
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

General Provider Information

NPI Number : 1427590850
Entity Type Code : Individual
Provider Name (Legal Business Name) : LENKA CERVENANOVA
Provider Business Mailing Address
First Line : PO BOX 12091
Second Line :
City : JACKSON
State : WY
Zip : 83002-2091
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 140 E BROADWAY AVE
Second Line :
City : JACKSON
State : WY
Zip : 83001-8632
Country : US
Telephone Number : 307-690-5577
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2016
Last Update Date : 11/16/2016

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Directions to “ LENKA CERVENANOVA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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