Individual
SHAWNA MARIA KAUTZMAN PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
255 N 30TH ST, LARAMIE, WY 82072-5140
(307) 761-1644
Mailing address
255 N 30TH ST, LARAMIE, WY 82072-5140
(307) 761-1644
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-397
WY
Other
Enumeration date
06/13/2009
Last updated
01/24/2012
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