Organization
SNOWY RANGE CONSULTING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK JOSEPH WATT PHD (PSYCHOLOGIST)
(307) 745-5414
Entity
Organization
Contact information
Practice address
526 REGENCY DR, LARAMIE, WY 82070-5106
(307) 745-5414
(307) 745-5138
Mailing address
526 REGENCY DR, LARAMIE, WY 82070-5106
(307) 745-5414
(307) 745-5138
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
199
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115175
—
WY
Enumeration date
04/24/2018
Last updated
04/24/2018
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