Individual
STEPHAN BADGETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
383 N MAIN ST, THAYNE, WY 83127
(626) 602-4818
Mailing address
PO BOX 2624, JACKSON, WY 83001-2624
(626) 602-4818
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-1148
WY
Other
Enumeration date
11/08/2019
Last updated
11/08/2019
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