Individual
STACIE R HENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
1120 BECK AVE, CODY, WY 82414
(307) 578-7770
Mailing address
1120 BECK AVE., CODY, WY 82414
(307) 578-7770
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/09/2011
Last updated
09/25/2013
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