Individual
CHARLES MICHAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PCSW
Contact information
Practice address
2300 FOOTHILL BLVD, ROCK SPRINGS, WY 82901-5610
(307) 352-6677
Mailing address
2300 FOOTHILL BLVD, ROCK SPRINGS, WY 82901-5610
(307) 352-6677
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
PCSW-429
WY
Other
Enumeration date
08/06/2010
Last updated
08/06/2010
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