Individual
MRS. DUSTY ROSE MCBRIDE-THOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.A.
Contact information
Practice address
521 W LOTT ST, BUFFALO, WY 82834-1642
(307) 684-5531
(307) 684-2912
Mailing address
521 W LOTT ST, BUFFALO, WY 82834-1642
(307) 684-5531
(307) 684-2912
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106072404
—
WY
Enumeration date
01/20/2010
Last updated
01/20/2010
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