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1154196665
DORTHEA A CLARK
CHEYENNE, WY
NPI
1154196665
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: WY PPC-1416)
Enumeration Date
2023-11-15
Last Update Date
2023-11-15
Business Address
DORTHEA A CLARK MA in Mental Health
4025 RAWLINS ST
CHEYENNE, WY 82001-1900
Phone number: 307-426-4797
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Mailing Address
DORTHEA A CLARK MA in Mental Health
4025 RAWLINS ST
CHEYENNE, WY 82001-1900
Phone number: 307-631-7381
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