Organization
COUNSELING AND PLAY THERAPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSE MAUDE HARRIET (OWNER)
(307) 217-2161
Entity
Organization
Contact information
Practice address
140 S MAIN ST, BUFFALO, WY 82834-1846
(307) 217-2161
(307) 684-9037
Mailing address
427 N ADAMS AVE, BUFFALO, WY 82834-1712
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
1139
WY
101YP2500X
Professional Counselor
Primary
807
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1124268354
NPI
—
01
—
1740597913
NPI
—
Enumeration date
11/20/2012
Last updated
11/20/2012
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