Individual
GILLIAN EMILY SIEGEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
507 S 4TH ST, LARAMIE, WY 82070-3753
(307) 399-4508
Mailing address
507 S 4TH ST, LARAMIE, WY 82070-3753
(307) 399-4508
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
075127
NY
Other
Enumeration date
03/26/2007
Last updated
11/28/2012
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