Healthcare Provider Details

I. General information

NPI: 1316886021
Provider Name (Legal Business Name): CHRISTY LEE DOAK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1129 CONVERSE CT
ROCK SPRINGS WY
82901-7101
US

IV. Provider business mailing address

1129 CONVERSE CT
ROCK SPRINGS WY
82901-7101
US

V. Phone/Fax

Practice location:
  • Phone: 307-350-5339
  • Fax:
Mailing address:
  • Phone: 307-350-5339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-1153
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: