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Jaqueline Fales, PEERSUPPORTSPECIAL
Peer Specialist in Cody, Wyoming
NPI 1962179903

Jaqueline Fales is a Peer Specialist based in Cody, WY. Jaqueline Fales practices in Cody, WY and has the professional credentials of PEERSUPPORTSPECIAL. The NPI Number for Jaqueline Fales is 1962179903 and holds a License No. 015 (Wyoming).

The current practice location address for Jaqueline Fales is 707 Sheridan Ave, Cody, WY and can be reached out via phone at 307-250-7063. You can also correspond with Jaqueline Fales through the mailing address at 707 SHERIDAN AVE, CODY, WY - 82414-3409 (mailing address contact number: 307-250-7063).

Location: 707 Sheridan Ave, Cody, WY, 82414-3409
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1962179903
Provider Name
Jaqueline Fales
Credential
PEERSUPPORTSPECIAL
Provider Entity Type
Individual
Gender
Female
Address
707 Sheridan Ave, Cody, WY, 82414-3409
Phone Number
307-250-7063
Fax Number
Provider Enumeration Date
08/26/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
707 Sheridan Ave
City
Cody
State
Wyoming
Zip
82414-3409
Phone Number
307-250-7063
Fax Number
person
Provider Business Mailing Address Details
Address
707 Sheridan Ave
City
Cody
State
Wyoming
Zip
82414-3409
Phone Number
307-250-7063
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
015 (Wyoming)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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