Organization
PROJECT BLUE WYOMING LLC
Active
Other names
Advanced Therapy Clinic Wyoming
Organization subpart
No
Provider details
NPI number
Authorized official
NACHIE LIEBERMAN (COO)
(845) 538-7443
Entity
Organization
Contact information
Practice address
30 N GOULD ST STE 10401, SHERIDAN, WY 82801-6317
(307) 201-2532
(307) 200-2465
Mailing address
30 N GOULD ST STE 10401, SHERIDAN, WY 82801-6317
(307) 201-2532
(307) 200-2465
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
12/31/2024
Last updated
12/31/2024
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