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General NPI Number Information
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NPI Number | 1992197602
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Entity Type | Organization
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Legal Business Name | COTTONWOOD COUNSELING & CONSULTING, LLC
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Dates
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Enumeration Date | 03/04/2015
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Last Update Date | 03/04/2015
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Provider Practice Location Address
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Address Line | 1050 N 3RD ST
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City | LARAMIE
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State | WY
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Zip | 82072-2544
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Country | US
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Telephone | 307-399-0629
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Fax |
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Provider Business Mailing Address
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Address Line | 8000 ANTELOPE VALLEY ST
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City | GILLETTE
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State | WY
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Zip | 82718-9392
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Country | US
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Telephone | 307-399-0629
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DARLA SNEATHEN
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Credential | LPC
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Telephone | 307-399-0629
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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