Individual
MR. PHILIP SHUPE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1900 LYNWOOD PL, CASPER, WY 82604-3384
(801) 597-5432
Mailing address
1900 LYNWOOD PL, CASPER, WY 82604-3384
(801) 597-5432
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
328017-3501
UT
1041C0700X
Clinical Social Worker
Primary
LCSW-821
WY
Other
Enumeration date
04/22/2014
Last updated
06/04/2015
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