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NPI Code Detail

MEDICARE: MS. JAMIE LYNN RETTINGER MA

MEDICARE: MS. JAMIE LYNN RETTINGER MA
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
2101Y00000XCounselorPPC-536WY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PPC-536OTHERWYSTATE LICENSE

General Provider Information

NPI Number : 1528213477
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JAMIE LYNN RETTINGER MA
Provider Business Mailing Address
First Line : 4989 N 3RD ST
Second Line :
City : LARAMIE
State : WY
Zip : 82072-9548
Country : US
Telephone Number : 307-745-8997
Fax Number :
Provider Business Practice Location Address
First Line : 4989 N 3RD ST
Second Line :
City : LARAMIE
State : WY
Zip : 82072-9548
Country : US
Telephone Number : 307-745-8997
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/19/2008
Last Update Date : 09/17/2013

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