Individual
DEMETRIA BALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
702 PLATINUM AVE, CODY, WY 82414-3423
(307) 213-9954
(307) 275-9843
Mailing address
6 ROAD 6PR, CODY, WY 82414-5700
(541) 404-4900
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
L12201
OR
1041C0700X
Clinical Social Worker
Primary
LCSW-1276
WY
Other
Enumeration date
03/14/2015
Last updated
09/12/2022
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