Individual
KC SANTISTEVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW, PCSW
Contact information
Practice address
2001 DEWAR DR, #270, ROCK SPRINGS, WY 82901-5773
(435) 764-5237
Mailing address
3672 S 100 W, NIBLEY, UT 84321-7983
(435) 764-5237
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
PCSW-645
WY
Other
Enumeration date
10/17/2016
Last updated
10/17/2016
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