Healthcare Provider Details

I. General information

NPI: 1891828752
Provider Name (Legal Business Name): SINKS CANYON THERAPIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 MAIN ST.
LANDER WY
82520
US

IV. Provider business mailing address

307 MAIN ST.
LANDER WY
82520
US

V. Phone/Fax

Practice location:
  • Phone: 307-332-2715
  • Fax:
Mailing address:
  • Phone: 307-332-2715
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA3000X
TaxonomyAugmentative Communication Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. KYLE KIENLEN-TRUJILLO
Title or Position: OWNER-SPEECH-LANGUAGE PATHOLOGIST
Credential: M.S., CCC-SLP
Phone: 307-332-2715