Individual
STEPHEN WARD DOMINICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW
Contact information
Practice address
1735 SHERIDAN AVE, SUITE 230, CODY, WY 82414-3855
(307) 587-8439
(307) 587-8439
Mailing address
1735 SHERIDAN AVE, SUITE 230, CODY, WY 82414-3855
(307) 587-8439
(307) 587-8439
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-187
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LCSW-187
LIC. CLINICAL SOCIAL WORK
WY
Enumeration date
05/31/2007
Last updated
07/08/2007
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