MEDICARE: MS. GAIL MORLEY-BRYANT MS

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
1	101YP2500X	Professional Counselor	70	WY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	312396	OTHER	WY	BS

General Provider Information

NPI Number	:	1750356606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GAIL MORLEY-BRYANT MS

Provider Business Mailing Address
First Line	:	PO BOX 718
Second Line	:
City	:	LARAMIE
State	:	WY
Zip	:	82073-0718
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1263 N 15TH ST
Second Line	:
City	:	LARAMIE
State	:	WY
Zip	:	82072-2343
Country	:	US
Telephone Number	:	307-745-8915
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2006
Last Update Date	:	07/08/2007

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