Individual
DR. GRANT GRIFFIN BOOSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1898 FORT RD # 116B, SHERIDAN, WY 82801-8320
(307) 675-3834
Mailing address
1898 FORT RD # 116B, SHERIDAN, WY 82801-8320
(307) 675-3834
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
801
WY
Other
Enumeration date
09/22/2022
Last updated
09/22/2022
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