Individual
LAURA CAROL LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
800 WERNER CT STE 300, CASPER, WY 82601
(307) 247-3901
Mailing address
PO BOX 36, LUSK, WY 82225-0036
(307) 752-9155
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW #828
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106402907
—
WY
Enumeration date
04/14/2011
Last updated
08/30/2018
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