Individual
JENNIFER SOFIE GULICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
640 E BROADWAY AVENUE, JACKSON, WY 83001
(307) 733-2046
Mailing address
PO BOX 1868, JACKSON, WY 83001-1868
(307) 733-2046
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
PPC-945
WY
101YP2500X
Professional Counselor
Primary
LPC-1735
WY
Other
Enumeration date
02/24/2017
Last updated
08/29/2018
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