Individual
DEANA LIN GUDMUNDSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
4 NORTH FORK ROAD, FORT WASHAKIE, WY 82514
(307) 332-6902
Mailing address
860 WASHAKIE ST, LANDER, WY 82520-2746
(307) 332-2868
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
COTA 577
WY
Other
Enumeration date
04/01/2009
Last updated
04/01/2009
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