Organization
LIVING WELL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRICIA R MILLER MSW (PRESIDENT)
(307) 234-9979
Entity
Organization
Contact information
Practice address
2510 E 15TH ST, SUITE 11, CASPER, WY 82609-4111
(307) 234-9979
(307) 234-9989
Mailing address
2510 E 15TH ST, SUITE 11, CASPER, WY 82609-4111
(307) 234-9979
(307) 234-9989
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
465
WY
1041C0700X
Clinical Social Worker
Primary
603
WY
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130674000
—
WY
Enumeration date
01/10/2011
Last updated
05/01/2015
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