Individual
TANYA L TOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
507 E 18TH ST, CHEYENNE, WY 82001-4617
(307) 637-7906
Mailing address
2919 THOMES AVE, CHEYENNE, WY 82001-2734
(307) 638-2164
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
413
WY
Other
Enumeration date
02/12/2008
Last updated
12/01/2008
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