Individual
MARIA VELASCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2617 E LINCOLNWAY STE G, CHEYENNE, WY 82001-5671
(307) 286-0921
Mailing address
2617 E LINCOLNWAY STE G, CHEYENNE, WY 82001-5671
(307) 286-0921
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-1718
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156171500
—
WY
Enumeration date
06/22/2020
Last updated
10/28/2024
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