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Individual

MS. MICHELE DOLORES DEHERRERA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CSW

Contact information

Practice address
1800 EDINBURGH, RAWLINS, WY 82301
(307) 324-8820
(307) 333-0261
Mailing address
804 W PINE ST, RAWLINS, WY 82301-5434
(307) 321-3950
(307) 333-0261

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
221
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
221
MENTAL HEALTH LICENSE CSW
WY
Enumeration date
08/28/2013
Last updated
08/28/2013
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