Healthcare Provider Details

I. General information

NPI: 1932993318
Provider Name (Legal Business Name): DYNAMIC REFLECTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2025
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1949 SUGARLAND DR STE 200
SHERIDAN WY
82801-5765
US

IV. Provider business mailing address

1949 SUGARLAND DR STE 200
SHERIDAN WY
82801-5765
US

V. Phone/Fax

Practice location:
  • Phone: 661-788-5354
  • Fax:
Mailing address:
  • Phone: 661-788-5354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: DR. KAITLYN CARD
Title or Position: CEO
Credential: PSYD
Phone: 661-788-5354