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General NPI Number Information
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NPI Number | 1518206465
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Entity Type | Organization
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Legal Business Name | ACTION LIFE SERVICES, LLC
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Dates
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Enumeration Date | 02/12/2013
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Last Update Date | 05/14/2013
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Provider Practice Location Address
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Address Line | 963 FORT ST #4
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City | BUFFALO
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State | WY
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Zip | 82834-2424
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Country | US
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Telephone | 307-217-2414
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1066
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City | BUFFALO
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State | WY
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Zip | 82834-1066
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Country | US
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Telephone | 307-217-2414
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Fax |
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Authorized Official
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Title or Position | SOCIAL WORKER
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Name | DANA L WILSON-HILL
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Credential | LCSW
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Telephone | 307-217-2141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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