Individual
ZACHERY PAUL SAMSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PCSW 766
Contact information
Practice address
821 W PERSHING BLVD, CHEYENNE, WY 82001-2537
(801) 657-1241
Mailing address
821 W PERSHING BLVD, CHEYENNE, WY 82001-2537
(801) 657-1241
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
766
WY
171M00000X
Case Manager/Care Coordinator
Primary
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
Other
Enumeration date
07/22/2013
Last updated
06/12/2023
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