Healthcare Provider Details

I. General information

NPI: 1376476267
Provider Name (Legal Business Name): MERANDA RICHARDS MA, PPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 W 27TH AVE
TORRINGTON WY
82240-1839
US

IV. Provider business mailing address

407 W 27TH AVE
TORRINGTON WY
82240-1839
US

V. Phone/Fax

Practice location:
  • Phone: 307-338-8099
  • Fax:
Mailing address:
  • Phone: 307-338-8099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberPPC-1651
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: