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Individual

GORDON L ROUPE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
BSW, CMHW

Contact information

Practice address
401 S 23RD ST, WORLAND, WY 82401-3725
(307) 347-6165
(307) 347-6166
Mailing address
401 S 23RD ST, WORLAND, WY 82401-3725
(307) 347-6165
(307) 347-6166

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CMHW-055
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
106352907
WY
05
106352908
WY
Enumeration date
03/19/2007
Last updated
04/08/2014
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