Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | LCSW-950 | WY |
NPI | 1003179649 |
---|---|
Provider Name | Gregory Stelzner |
First Address | Cheyenne, WY 82001-2125 |
Second Address | Cheyenne, WY 82001-5511 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2012 |
Last Update Date | 02/04/2021 |