Individual
DEREK WAITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1898 FORT RD, SHERIDAN, WY 82801-8320
(307) 675-3150
Mailing address
1898 FORT RD, SHERIDAN, WY 82801-8320
(307) 675-3150
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-1633
WY
Other
Enumeration date
01/16/2019
Last updated
11/21/2024
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