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Organization
PROJECT BLUE WYOMING LLC
Active
Organization
PROJECT BLUE WYOMING LLC
Active
Other names
Advanced Therapy Clinic Wyoming
Organization subpart
No
Provider details
NPI number
Authorized official
NACHIE LIEBERMAN (COO)
(845) 538-7443
Entity
Organization
Contact information
Practice address
30 N GOULD ST STE 10401, SHERIDAN, WY 82801-6317
(307) 201-2532
(307) 200-2465
Mailing address
30 N GOULD ST STE 10401, SHERIDAN, WY 82801-6317
(307) 201-2532
(307) 200-2465
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
12/31/2024
Last updated
12/31/2024
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