Healthcare Provider Details

I. General information

NPI: 1497465421
Provider Name (Legal Business Name): KRISTINE LYNN SANDLIAN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2022
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 W 21ST AVE
TORRINGTON WY
82240-2721
US

IV. Provider business mailing address

136 W 21ST AVE
TORRINGTON WY
82240-2721
US

V. Phone/Fax

Practice location:
  • Phone: 307-532-2119
  • Fax:
Mailing address:
  • Phone: 307-532-2119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-2378
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: