Individual
MRS. VIRGINIA S VASSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1221 W 5TH SREET, SHERIDAN, WY 82801-2701
(307) 674-4405
(307) 673-5167
Mailing address
1221 W 5TH ST, SHERIDAN, WY 82801-2701
(307) 674-4405
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
2745
ND
1041C0700X
Clinical Social Worker
Primary
567
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21751
MEDICARE PTAN
WY
05
—
54516
—
ND
Enumeration date
10/02/2006
Last updated
04/02/2008
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