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General NPI Number Information
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NPI Number | 1639092414
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Entity Type | Individual
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Provider Name | JOSEPH MIRELES
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Gender | Male
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Dates
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Enumeration Date | 07/30/2026
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Last Update Date | 07/30/2026
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Provider Practice Location Address
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Address Line | 701 ANTLER DR
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City | CASPER
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State | WY
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Zip | 82601-1726
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Country | US
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Telephone | 307-374-6463
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Fax |
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Provider Business Mailing Address
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Address Line | 3501 NAVARRE RD
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City | CASPER
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State | WY
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Zip | 82604-4876
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | PPC-1671
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License Number State | WY
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