Provider Demographics
NPI:1730104480
Name:ANDREWS, BRUCE L (MS)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:L
Last Name:ANDREWS
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1842 SUGARLAND DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-5775
Mailing Address - Country:US
Mailing Address - Phone:307-673-4960
Mailing Address - Fax:307-673-4951
Practice Address - Street 1:1842 SUGARLAND DR
Practice Address - Street 2:SUITE 103
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-5775
Practice Address - Country:US
Practice Address - Phone:307-673-4960
Practice Address - Fax:307-673-4951
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLPC-159101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health