Individual
MARY HENNICKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
821 W PERSHING BLVD, CHEYENNE, WY 82001-2537
(307) 638-4625
(307) 635-3965
Mailing address
821 W PERSHING BLVD, CHEYENNE, WY 82001-2537
(307) 638-4625
(307) 635-3965
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW-248
WY
Other
Enumeration date
11/04/2015
Last updated
11/04/2015
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