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Individual

MS. KARLA JEAN GILMORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BSW, LAT

Contact information

Practice address
510 W 29TH ST, CHEYENNE, WY 82001-2760
(307) 632-9362
Mailing address
510 W 29TH ST, CHEYENNE, WY 82001-2760
(307) 632-9362

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
169A
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
310825
BS
Enumeration date
07/12/2005
Last updated
03/23/2015
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