Organization
MOURNING GLORY COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TISA M SUCHER LCSW (LICENSED CLINICAL SOCIAL WORKER)
(307) 235-3333
Entity
Organization
Contact information
Practice address
1300 E A ST STE 201, CASPER, WY 82601-2252
(307) 235-3333
(307) 266-5155
Mailing address
1300 E A ST STE 201, CASPER, WY 82601-2252
(307) 235-3333
(307) 266-5155
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
456
WY
Other
Enumeration date
12/05/2016
Last updated
12/05/2016
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