Organization
WYOMING MENTAL HEALTH CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE HOUSE (ADMINISTRATOR)
(307) 851-9360
Entity
Organization
Contact information
Practice address
930 MOUNTAIN VIEW CT, LANDER, WY 82520-3527
(307) 851-9360
Mailing address
930 MOUNTAIN VIEW CT, LANDER, WY 82520-3527
(307) 851-9360
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619234044
—
WY
Enumeration date
10/07/2024
Last updated
10/07/2024
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