Individual
TINA SAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2300 FOOTHILL BLVD, ROCK SPRINGS, WY 82901-5610
(307) 352-6677
Mailing address
2300 FOOTHILL BLVD, ROCK SPRINGS, WY 82901-5610
(307) 352-6677
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/09/2009
Last updated
04/09/2009
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