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Individual

CORY DEAN CARPENTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PCSW, CAP

Contact information

Practice address
306 N BENT ST, POWELL, WY 82435-2338
(307) 202-1067
Mailing address
555 MOUNTAIN VIEW ST, POWELL, WY 82435-1720
(307) 202-1067
(307) 460-7029

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
152
WY
1041C0700X
Clinical Social Worker
Primary
PCSW-843
WY

Other

Enumeration date
12/02/2011
Last updated
06/05/2019
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