Individual
KYM FRANCES CODALLOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW,ACSW,LCSW,CPRP
Contact information
Practice address
615 ROGER CANYON RD, LARAMIE, WY 82072-8902
(209) 247-3686
Mailing address
PO BOX 1733, LARAMIE, WY 82073-1733
(209) 247-3686
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
25688
CA
Other
Enumeration date
03/12/2007
Last updated
10/12/2022
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