Individual
MICHAEL SHOUVLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PCSW
Contact information
Practice address
640 E BROADWAY AVE, JACKSON, WY 83001-8642
(307) 733-2046
Mailing address
PO BOX 1868, JACKSON, WY 83001-1868
(307) 733-2046
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
PCSW-1110
WY
Other
Enumeration date
04/05/2024
Last updated
04/05/2024
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