Provider Demographics
NPI:1518019736
Name:WYOMING CHILD AND FAMILY DEVELOPMENT, INC.
Entity Type:Organization
Organization Name:WYOMING CHILD AND FAMILY DEVELOPMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MACLAINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-358-3901
Mailing Address - Street 1:PO BOX 470
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:WY
Mailing Address - Zip Code:82633-0470
Mailing Address - Country:US
Mailing Address - Phone:307-358-3901
Mailing Address - Fax:
Practice Address - Street 1:630 ERWIN ST
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:WY
Practice Address - Zip Code:82633-2848
Practice Address - Country:US
Practice Address - Phone:307-358-3901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty