Individual
JASON HENDRIK UITTERDYK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1465 N 4TH ST, #119, LARAMIE, WY 82072-2066
(307) 721-0700
Mailing address
1465 N 4TH ST, #119, LARAMIE, WY 82072-2066
(307) 721-0700
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC-1277
WY
Other
Enumeration date
08/15/2013
Last updated
08/15/2013
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