Individual
MATTHEW TY BARRUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1106 JULIE LN, POWELL, WY 82435-1632
(307) 271-7460
Mailing address
862 RISEN SON RD, POWELL, WY 82435-8473
(307) 254-0575
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-582
WY
Other
Enumeration date
06/06/2011
Last updated
06/06/2011
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