| Rehabilitation Enterprises Of Northeastern Wyoming | |
|
1969 S Sheridan Ave Sheridan WY 82801-6108 | |
| (307) 672-7481 | |
| (307) 674-5117 |
| Full Name | Rehabilitation Enterprises Of Northeastern Wyoming |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 1969 S Sheridan Ave, Sheridan, Wyoming |
| Authorized Official Name and Position | Larry W Samson (PRESIDENT AND CEO) |
| Authorized Official Contact | 3076727481 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rehabilitation Enterprises Of Northeastern Wyoming 1969 S Sheridan Ave Sheridan WY 82801-6108 Ph: (307) 672-7481 | Rehabilitation Enterprises Of Northeastern Wyoming 1969 S Sheridan Ave Sheridan WY 82801-6108 Ph: (307) 672-7481 |
| NPI Number | 1689716227 |
|---|---|
| Provider Enumeration Date | 02/12/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689716227 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 709001 (Wyoming) | Primary |
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