| Anne C Fitzgerald, Phd, Llc | |
|
1465 N 4th St Ste 113 Laramie WY 82072-2066 | |
| (073) 997-4993 | |
| (307) 745-3221 |
| Full Name | Anne C Fitzgerald, Phd, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1465 N 4th St Ste 113, Laramie, Wyoming |
| Authorized Official Name and Position | Anne Catherine Fitzgerald (OWNER-PROVIDER) |
| Authorized Official Contact | 3073997499 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anne C Fitzgerald, Phd, Llc 1465 N 4th St Ste 113 Laramie WY 82072-2066 Ph: (073) 997-4993 | Anne C Fitzgerald, Phd, Llc 1465 N 4th St Ste 113 Laramie WY 82072-2066 Ph: (073) 997-4993 |
| NPI Number | 1639328040 |
|---|---|
| Provider Enumeration Date | 09/10/2008 |
| Last Update Date | 12/15/2021 |
| Certification Date | 12/15/2021 |
| Medicare PECOS PAC ID | 7214005354 |
|---|---|
| Medicare Enrollment ID | O20081002000537 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639328040 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 308 (Wyoming) | Primary |
| Provider Name | Anne C Fitzgerald |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1154580140 PECOS PAC ID: 4082782107 Enrollment ID: I20081002000398 |
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