MEDICARE: MS. JANA K SALTENBERGER LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	218	WY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	313300	OTHER	WY	BS

General Provider Information

NPI Number	:	1992703094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JANA K SALTENBERGER LCSW

Provider Business Mailing Address
First Line	:	502 S 4TH ST
Second Line	:
City	:	LARAMIE
State	:	WY
Zip	:	82070-3704
Country	:	US
Telephone Number	:	307-755-1000
Fax Number	:

Provider Business Practice Location Address
First Line	:	502 S 4TH ST
Second Line	:
City	:	LARAMIE
State	:	WY
Zip	:	82070-3704
Country	:	US
Telephone Number	:	307-755-1000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	05/13/2020

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