Individual
PATTY JO. LOCKHART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1419 E SHERIDAN ST, LARAMIE, WY 82070-4151
(307) 703-1111
Mailing address
1419 E SHERIDAN ST, LARAMIE, WY 82070-4151
(307) 703-1111
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
251S00000X
Community/Behavioral Health Agency
—
WY
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760882187
—
WY
Enumeration date
09/04/2014
Last updated
03/11/2021
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