Organization
INTEGRATIVE WELL-BEING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN L BERTILSON LCSW (OWNER)
(307) 760-5450
Entity
Organization
Contact information
Practice address
1622 SHIELD ST, LARAMIE, WY 82072-2333
(307) 760-5450
Mailing address
1622 SHIELD ST, LARAMIE, WY 82072-2333
(307) 760-5450
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW606
WY
Other
Enumeration date
09/09/2013
Last updated
09/09/2013
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