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General NPI Number Information
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NPI Number | 1538872536
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Entity Type | Organization
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Legal Business Name | TIMBER THERAPY, LLC
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Dates
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Enumeration Date | 01/04/2023
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Last Update Date | 07/19/2023
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Provider Practice Location Address
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Address Line | 4733 W YELLOWSTONE HWY
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City | MILLS
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State | WY
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Zip | 82604-2209
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Country | US
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Telephone | 307-439-6424
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 50373
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City | CASPER
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State | WY
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Zip | 82605-0373
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Country | US
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Telephone | 307-439-6424
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Fax |
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Authorized Official
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Title or Position | LCSW, OWNER
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Name | MR. TIMOTHY P. PORTER
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Credential | LCSW
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Telephone | 307-439-6424
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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