Provider Demographics
NPI:1346709847
Name:MANTHEI-ROBINSON, MARI'
Entity Type:Individual
Prefix:
First Name:MARI'
Middle Name:
Last Name:MANTHEI-ROBINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 693
Mailing Address - Street 2:
Mailing Address - City:MILLS
Mailing Address - State:WY
Mailing Address - Zip Code:82644-0693
Mailing Address - Country:US
Mailing Address - Phone:307-277-5667
Mailing Address - Fax:
Practice Address - Street 1:4855 W HIGHWAY ST
Practice Address - Street 2:
Practice Address - City:MILLS
Practice Address - State:WY
Practice Address - Zip Code:82604-2494
Practice Address - Country:US
Practice Address - Phone:307-277-5667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-14
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172V00000XOther Service ProvidersCommunity Health Worker
No175T00000XOther Service ProvidersPeer Specialist
No251S00000XAgenciesCommunity/Behavioral Health