Individual
OLIVIA GERRISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1642 PALMER DR APT 11, LARAMIE, WY 82070-8213
(801) 663-0340
Mailing address
1642 PALMER DR APT 11, LARAMIE, WY 82070-8213
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-1242
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LCSW-1242
WYOMING MENTAL HEALTH LICENSING BOARD
WY
Enumeration date
04/02/2020
Last updated
04/02/2020
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