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Individual

DR. DEIRDRE DANETTE RAINER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
550 MAIN ST, SUITE 4, LANDER, WY 82520-3089
(307) 349-5027
(307) 335-9973
Mailing address
830 S 5TH ST, LANDER, WY 82520-3633
(307) 349-5027
(307) 335-9973

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
342
WY
103TC0700X
Clinical Psychologist
Primary
PSY 1239
HI
103TC0700X
Clinical Psychologist
PSY 9892
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
118897600
WY
Enumeration date
05/02/2007
Last updated
11/26/2013
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