Organization
REHABILITATION ENTERPRISES OF NORTHEASTERN WYOMING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY W SAMSON (PRESIDENT AND CEO)
(307) 672-7481
Entity
Organization
Contact information
Practice address
1969 S SHERIDAN AVE, SHERIDAN, WY 82801-6108
(307) 672-7481
(307) 674-5117
Mailing address
1969 S SHERIDAN AVE, SHERIDAN, WY 82801-6108
(307) 672-7481
(307) 674-5117
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
709001
WY
Other
Enumeration date
02/12/2007
Last updated
08/22/2020
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