Healthcare Provider Details

I. General information

NPI: 1437259017
Provider Name (Legal Business Name): MARILYN K. YEE PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1465 N 4TH ST SUITE 101
LARAMIE WY
82072-2066
US

IV. Provider business mailing address

1421 RENSHAW ST
LARAMIE WY
82072-1830
US

V. Phone/Fax

Practice location:
  • Phone: 307-399-2567
  • Fax:
Mailing address:
  • Phone: 307-399-2567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number374
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: