Individual
SHANNON MARIE DEWITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAP
Contact information
Practice address
231 S WILSON ST, CASPER, WY 82601-2941
(307) 265-3791
(307) 265-4480
Mailing address
231 S WILSON ST, CASPER, WY 82601-2941
(307) 265-3791
(307) 265-4480
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CAP-187
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101YP2500X
—
WY
Enumeration date
06/09/2021
Last updated
06/09/2021
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