Individual
ANDREA CLUBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MRC, CRC, PLPC
Contact information
Practice address
821 W PERSHING BLVD, CHEYENNE, WY 82001-2537
(307) 421-9329
Mailing address
821 W PERSHING BLVD, CHEYENNE, WY 82001-2537
(307) 421-9329
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
PPC-104
WY
Other
Enumeration date
07/27/2023
Last updated
07/31/2023
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