Individual
STEPHANIE IDALSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCM
Contact information
Practice address
140 S MAIN ST, BUFFALO, WY 82834-1846
(989) 255-4508
Mailing address
140 S MAIN ST, BUFFALO, WY 82834-1846
(989) 255-4508
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1760
WY
Other
Enumeration date
01/06/2019
Last updated
01/06/2019
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