Individual
MS. MARY LOU GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2526 SEYMOUR AVE, CHEYENNE, WY 82001
(307) 634-9653
(307) 638-8256
Mailing address
2526 SEYMOUR AVE, CHEYENNE, WY 82001
(307) 634-9653
(307) 638-8256
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW 340
WY
Other
Enumeration date
04/25/2007
Last updated
07/17/2008
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