Healthcare Provider Details

I. General information

NPI: 1154742203
Provider Name (Legal Business Name): SONJA H CAHHAL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2013
Last Update Date: 02/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

238 N MAIN ST STE 6
BUFFALO WY
82834-1747
US

IV. Provider business mailing address

701 W KEAYS ST
BUFFALO WY
82834-2585
US

V. Phone/Fax

Practice location:
  • Phone: 307-267-7360
  • Fax:
Mailing address:
  • Phone: 307-267-7360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-1138
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: