Individual
JUSTIN BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSW
Contact information
Practice address
721 W MAPLE ST, RAWLINS, WY 82301-5447
(307) 324-7156
(307) 328-1651
Mailing address
721 W MAPLE ST, RAWLINS, WY 82301-5447
(307) 324-7156
(307) 328-1651
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW-252
WY
Other
Enumeration date
03/01/2016
Last updated
05/18/2016
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