Individual
EARL H FAULKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
6900 ALDEN DR, CHEYENNE, WY, FE WARREN AFB, WY 82005-3906
(307) 773-2998
Mailing address
6900 ALDEN DR, CHEYENNE, WY, FE WARREN AFB, WY 82005-3906
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
PHD-419
WY
101YM0800X
Mental Health Counselor
PHD-419
WY
103T00000X
Psychologist
Primary
PHD-419
WY
103TA0400X
Addiction (Substance Use Disorder) Psychologist
PHD-419
WY
103TC2200X
Clinical Child & Adolescent Psychologist
PHD-419
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122963000
—
WY
Enumeration date
05/01/2007
Last updated
06/08/2015
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