Healthcare Provider Details

I. General information

NPI: 1346570686
Provider Name (Legal Business Name): SUNNY TRABING MSW, PCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2010
Last Update Date: 08/10/2021
Certification Date: 07/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1110 MAJOR AVE
RIVERTON WY
82501-2342
US

IV. Provider business mailing address

14 GREAT PLAINS RD
ARAPAHOE WY
82510
US

V. Phone/Fax

Practice location:
  • Phone: 307-856-6587
  • Fax:
Mailing address:
  • Phone: 307-856-9281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberPCSW 287
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: