Provider Demographics
NPI:1760653596
Name:ALLIANCE FOR GROWTH
Entity Type:Organization
Organization Name:ALLIANCE FOR GROWTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:E
Authorized Official - Last Name:ROBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:307-742-4769
Mailing Address - Street 1:1050 N 3RD ST
Mailing Address - Street 2:SUITE B-1
Mailing Address - City:LARAMIE
Mailing Address - State:WY
Mailing Address - Zip Code:82072-2544
Mailing Address - Country:US
Mailing Address - Phone:307-742-4769
Mailing Address - Fax:307-742-6702
Practice Address - Street 1:1050 N 3RD ST
Practice Address - Street 2:SUITE B-1
Practice Address - City:LARAMIE
Practice Address - State:WY
Practice Address - Zip Code:82072-2538
Practice Address - Country:US
Practice Address - Phone:307-742-4769
Practice Address - Fax:307-742-6702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLPC-390B101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty