Individual
TINA TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
184 SEMINOLE DR, EVANSTON, WY 82930-6600
(307) 679-1822
Mailing address
184 SEMINOLE DR, EVANSTON, WY 82930-6600
(307) 679-1822
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-423
WY
Other
Enumeration date
07/27/2007
Last updated
08/27/2015
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