Individual
DR. GIBSON BUCKLEY CONDIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1054 VALI ROAD, POWELL, WY 82435
(307) 754-3860
(307) 754-0920
Mailing address
1054 VALI ROAD, POWELL, WY 82435
(307) 754-3860
(307) 754-0920
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
SP03
WY
Other
Enumeration date
10/06/2006
Last updated
07/09/2007
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