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General NPI Number Information
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NPI Number | 1578712865
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Entity Type | Individual
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Provider Name | MRS. STARLA F CHORD
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Gender | Female
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Dates
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Enumeration Date | 09/11/2008
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Last Update Date | 09/11/2008
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Provider Practice Location Address
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Address Line | 501 S BURMA AVE CCMH 5TH FLOOR
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City | GILLETTE
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State | WY
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Zip | 82716-3426
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Country | US
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Telephone | 307-660-7297
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Fax | 307-688-5015
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Provider Business Mailing Address
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Address Line | 501 S BURMA AVE P.O. BOX 3011
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City | GILLETTE
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State | WY
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Zip | 82716-3426
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Country | US
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Telephone | 307-688-5000
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Fax | 307-688-5015
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 251S00000XW
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License Number State | WY
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