Individual
PHILLIP EDWARD ARCHIBALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
121 S 4TH ST, THERMOPOLIS, WY 82443-2634
(307) 864-3138
(307) 864-3139
Mailing address
121 S 4TH ST, THERMOPOLIS, WY 82443-2634
(307) 864-3138
(307) 864-3139
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-1081
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
143715100
—
WY
Enumeration date
02/03/2016
Last updated
12/11/2017
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