| Project Blue Wyoming Llc | |
|
30 N Gould St Ste 10401 Sheridan WY 82801-6317 | |
| (307) 201-2532 | |
| (307) 200-2465 |
| Full Name | Project Blue Wyoming Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 30 N Gould St Ste 10401, Sheridan, Wyoming |
| Authorized Official Name and Position | Nachie Lieberman (COO) |
| Authorized Official Contact | 8455387443 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Project Blue Wyoming Llc 30 N Gould St Ste 10401 Sheridan WY 82801-6317 Ph: (307) 201-2532 | Project Blue Wyoming Llc 30 N Gould St Ste 10401 Sheridan WY 82801-6317 Ph: (307) 201-2532 |
| NPI Number | 1770392144 |
|---|---|
| Provider Enumeration Date | 12/31/2024 |
| Last Update Date | 12/31/2024 |
| Certification Date | 12/31/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770392144 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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