| Summit Psychological Services Llc | |
|
182 N Main St Buffalo WY 82834-1727 | |
| (307) 684-9360 | |
| (307) 684-5187 |
| Full Name | Summit Psychological Services Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 182 N Main St, Buffalo, Wyoming |
| Authorized Official Name and Position | Timothy A Blaney (OWNER) |
| Authorized Official Contact | 3076849360 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Summit Psychological Services Llc 182 N Main St Buffalo WY 82834-1727 Ph: (307) 684-9360 | Summit Psychological Services Llc 182 N Main St Buffalo WY 82834-1727 Ph: (307) 684-9360 |
| NPI Number | 1659672616 |
|---|---|
| Provider Enumeration Date | 11/08/2010 |
| Last Update Date | 11/08/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659672616 | NPI | - | NPPES |
| 117880601 | Medicaid | WY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 328 (Wyoming) | Primary |
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