| Dan Cossaboon Group | |
|
1001 14th St Cody WY 82414-3745 | |
| (307) 527-5432 | |
| Not Available |
| Full Name | Dan Cossaboon Group |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 1001 14th St, Cody, Wyoming |
| Authorized Official Name and Position | Daniel S Cossaboon (DIRECTOR) |
| Authorized Official Contact | 3072507527 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dan Cossaboon Group 1001 14th St Cody WY 82414-3745 Ph: (307) 527-5432 | Dan Cossaboon Group 1001 14th St Cody WY 82414-3745 Ph: (307) 527-5432 |
| NPI Number | 1881948800 |
|---|---|
| Provider Enumeration Date | 10/29/2012 |
| Last Update Date | 10/29/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881948800 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 440 (Wyoming) | Primary |
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