Individual
MARY BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1221 W 5TH ST, SHERIDAN, WY 82801-2701
(307) 674-4405
Mailing address
1221 W 5TH ST, SHERIDAN, WY 82801-2701
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
PCSW-804
WY
Other
Enumeration date
08/28/2018
Last updated
08/28/2018
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