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Individual

ALYSE PFANKUCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA

Contact information

Practice address
1918 THOMES AVE, CHEYENNE, WY 82001-3527
(307) 313-2777
Mailing address
4726 MOUNTAIN RD APT 520, CHEYENNE, WY 82009-5157
(307) 221-0317

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
LPC-2270
WY
101YP2500X
Professional Counselor
130923
IA
101YP2500X
Professional Counselor
Primary

Other

Enumeration date
11/03/2021
Last updated
04/05/2025
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