Individual
BRIAN ALAN DASKIVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2360 E PERSHING BLVD, CHEYENNE, WY 82001-5356
(307) 778-7550
Mailing address
PO BOX 22196, CHEYENNE, WY 82003-2118
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
320
MT
Other
Enumeration date
11/10/2009
Last updated
10/06/2013
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