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General NPI Number Information
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NPI Number | 1275883902
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Entity Type | Organization
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Legal Business Name | CHILD & FAMILY COUNSELING LLC
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Dates
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Enumeration Date | 09/10/2012
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Last Update Date | 09/10/2012
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Provider Practice Location Address
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Address Line | 136 NORTH NICHOLS
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City | CASPER
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State | WY
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Zip | 82601-1816
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Country | US
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Telephone | 307-265-6420
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Fax | 307-265-4332
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Provider Business Mailing Address
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Address Line | P.O. BOX 1693
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City | CASPER
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State | WY
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Zip | 82602-1693
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Country | US
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Telephone | 307-265-6420
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Fax | 307-265-4332
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Authorized Official
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Title or Position | OWNER/COUNSELOR
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Name | MS. TONYA LYNN YELTON
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Credential | MA, LPC, RPT-S
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Telephone | 307-265-6420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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