Individual
LORRY STUFFLEBEAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
70 3RD AVE, AFTON, WY 83110-8311
(307) 522-1541
(307) 459-6800
Mailing address
PO BOX 1474, AFTON, WY 83110-1474
(307) 522-1541
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033695804
BLUE CROSS BLUE SHIELD OF WYOMING
WY
Enumeration date
07/16/2018
Last updated
08/23/2022
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