Individual
THOMAS BOUGSTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2321 DUNN AVE, CHEYENNE, WY 82001-3214
(307) 634-1480
Mailing address
2321 DUNN AVE, CHEYENNE, WY 82001-3214
(307) 634-1480
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
WY134
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
138818
MHN
WY
01
—
178429
VALUE OPTIONS
WY
01
—
313242
BS OF WY
WY
Enumeration date
09/04/2006
Last updated
01/13/2013
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