Provider Demographics
NPI:1861982084
Name:DREW, KAREN (CLINICAL SOCIAL WORK)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:DREW
Suffix:
Gender:F
Credentials:CLINICAL SOCIAL WORK
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:LARAMIE
Mailing Address - State:WY
Mailing Address - Zip Code:82070-3611
Mailing Address - Country:US
Mailing Address - Phone:307-755-6463
Mailing Address - Fax:307-755-6460
Practice Address - Street 1:311 S 2ND ST
Practice Address - Street 2:
Practice Address - City:LARAMIE
Practice Address - State:WY
Practice Address - Zip Code:82070-3611
Practice Address - Country:US
Practice Address - Phone:307-755-6463
Practice Address - Fax:307-755-6460
Is Sole Proprietor?:No
Enumeration Date:2018-05-14
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY7411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical