Individual
MICHAEL ALAN DIETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
516 E 18TH ST, CHEYENNE, WY 82001-4618
(307) 220-3901
(307) 369-4188
Mailing address
516 E 18TH ST, CHEYENNE, WY 82001-4618
(307) 220-3901
(307) 369-4188
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC 893
WY
Other
Enumeration date
03/19/2009
Last updated
08/22/2014
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