Provider Information for 1114563905
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MARY JO GREENWOOD LCSW
Organization Subpart: NO
NPI: 1114563905
Last Updated: 2020-05-22
Certification Date: 2020-05-22
Certification Date: 2020-05-22
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1114563905 | ||||||||
| Enumeration Date | 2019-11-27 | ||||||||
| NPI Type | NPI-2 Organization | ||||||||
| Status | Active | ||||||||
| Authorized Official Information | Name: MARY JO GREENWOOD LCSW Title: Owner Phone: 3077100503 | ||||||||
| Mailing Address | PO BOX 568 SARATOGA, WY 82331-0568 United States Phone: 307-326-5566 | Fax: | ||||||||
| Primary Practice Address | 106 N. RIVER STREET SARATOGA, WY 82331-8233 United States Phone: 307-710-0503 | Fax: | ||||||||
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