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Individual

MS. BRENDA CATHERINE KOFFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
1954 W MARIPOSA PKWY, WHEATLAND, WY 82201-3102
(307) 322-3190
(307) 322-3198
Mailing address
403 9TH ST, WHEATLAND, WY 82201-2909

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
741
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
313262
BS
WY
Enumeration date
07/27/2005
Last updated
07/08/2007
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