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General NPI Number Information
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NPI Number | 1962882233
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Entity Type | Organization
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Legal Business Name | INSPIRE PSYCHOLOGICAL CENTER, LLC
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Dates
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Enumeration Date | 06/02/2015
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Last Update Date | 05/10/2016
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Provider Practice Location Address
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Address Line | 632 COFFEEN AVE
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City | SHERIDAN
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State | NY
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Zip | 82801
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Country | US
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Telephone | 307-655-5510
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Fax |
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Provider Business Mailing Address
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Address Line | 632 COFFEEN AVE
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City | SHERIDAN
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State | WY
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Zip | 82801-5314
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Country | US
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Telephone | 307-655-5510
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. VIVIANNE LEMOS TRAN
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Credential | PSY.D.
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Telephone | 307-679-9057
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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