Individual
SUSANNA BIRD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
314 E 21ST ST, CHEYENNE, WY 82001-3712
(307) 632-7619
Mailing address
612 GRAMERCY DR, CHEYENNE, WY 82009-5910
(801) 362-0747
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-1109
WY
Other
Enumeration date
02/14/2022
Last updated
11/07/2022
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