Healthcare Provider Details

I. General information

NPI: 1619975729
Provider Name (Legal Business Name): BARBARA B DOLBY MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2005
Last Update Date: 01/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2321 DUNN AVE
CHEYENNE WY
82001-3214
US

IV. Provider business mailing address

2321 DUNN AVE
CHEYENNE WY
82001-3214
US

V. Phone/Fax

Practice location:
  • Phone: 307-638-4880
  • Fax:
Mailing address:
  • Phone: 307-638-4880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number126
License Number StateWY
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number989602
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: