Individual
MICKIE NEWBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1490 GREGORY LN, JACKSON, WY 83001-9021
(307) 699-4047
Mailing address
PO BOX 2299, JACKSON, WY 83001-2299
(307) 699-4047
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-36165
ID
Other
Enumeration date
01/31/2020
Last updated
01/31/2020
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