Individual
COREY WENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPC, LAT
Contact information
Practice address
1301 S WISCONSIN AVE, CASPER, WY 82609-2936
(307) 472-5433
(307) 337-3705
Mailing address
PO BOX 552, CASPER, WY 82602-0552
(307) 797-4683
(307) 337-3705
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LAT 286
WY
101YP2500X
Professional Counselor
Primary
LPC 817
WY
Other
Enumeration date
10/22/2009
Last updated
03/11/2016
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