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Individual

GARTH RAY SHANKLIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.S., LPC

Contact information

Practice address
125 COLLEGE DR, CASPER, WY 82601-4612
(307) 268-2696
Mailing address
3961 CRYSTIE LN, CASPER, WY 82609-2338
(307) 267-2111
(307) 237-5568

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
026
WY
101YP2500X
Professional Counselor
Primary
007
WY

Other

Enumeration date
10/26/2012
Last updated
10/26/2012
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