Provider Demographics
NPI:1649533811
Name:WARDLE, HARRIET ELIZABETH (MSW)
Entity type:Individual
Prefix:MS
First Name:HARRIET
Middle Name:ELIZABETH
Last Name:WARDLE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12823
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:WY
Mailing Address - Zip Code:83002-2823
Mailing Address - Country:US
Mailing Address - Phone:307-690-0164
Mailing Address - Fax:
Practice Address - Street 1:3850 N WILDERNESS DR
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:WY
Practice Address - Zip Code:83014
Practice Address - Country:US
Practice Address - Phone:307-733-8210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool