Individual
MS. LAATASHA RUDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSW, CSW
Contact information
Practice address
604 E 25TH ST, CHEYENNE, WY 82001-3133
(307) 637-3953
(307) 638-6805
Mailing address
604 E 25TH ST, CHEYENNE, WY 82001-3133
(307) 637-3953
(307) 638-6805
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
165
WY
Other
Enumeration date
04/06/2009
Last updated
04/15/2011
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