Provider Demographics
NPI:1134403272
Name:DANFORD, ROBERT A
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:A
Last Name:DANFORD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 S JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-2909
Mailing Address - Country:US
Mailing Address - Phone:307-265-2555
Mailing Address - Fax:866-866-4158
Practice Address - Street 1:336 S JACKSON ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2909
Practice Address - Country:US
Practice Address - Phone:307-265-2555
Practice Address - Fax:866-866-4158
Is Sole Proprietor?:No
Enumeration Date:2011-10-07
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLPC-1230101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional