Individual
SHAWN HUMBERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
420 DEANNE AVE, NEWCASTLE, WY 82701-2936
(307) 746-4456
Mailing address
909 LONG DR STE C, SHERIDAN, WY 82801-3282
(307) 672-8958
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
ICPR-008
WY
Other
Enumeration date
08/31/2020
Last updated
02/18/2022
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