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1710574801
JERAD LEISCH
ROCK SPRINGS, WY
NPI
1710574801
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: WY RBT-20-149038)
Enumeration Date
2020-12-23
Last Update Date
2020-12-23
Business Address
JERAD LEISCH
2632 FOOTHILL BLVD
ROCK SPRINGS, WY 82901-4756
Phone number: 307-212-3284
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Mailing Address
JERAD LEISCH
310 E BROADWAY AVE
JACKSON, WY 83001-8636
Phone number: 307-212-3284
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