Individual
LISA OLIVIA FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA LPC
Contact information
Practice address
401 S 23RD ST, WORLAND, WY 82401-3725
(307) 347-6165
(307) 347-6166
Mailing address
1807 CREST WAY, WORLAND, WY 82401-2522
(307) 347-4842
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LPC-2122
WY
101YA0400X
Addiction (Substance Use Disorder) Counselor
PPC-1234
WY
101YP2500X
Professional Counselor
Primary
LPC-2122
WY
Other
Enumeration date
09/24/2006
Last updated
03/08/2024
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