Individual
MIA SHIFRAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
151 W. BRUNDAGE STREET, SHERIDAN, WY 82801
(307) 674-1668
(307) 674-1667
Mailing address
151 W BRUNDAGE ST, SHERIDAN, WY 82801-4217
(307) 674-1668
(307) 674-1667
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
261QM0801X
—
WY
Enumeration date
06/08/2017
Last updated
07/21/2022
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