Doctor Name: | CARLA KOEGEN |
NPI Number: | 1043598303 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW |
License Number: | 548 |
Business Practice Address: | 1277 N 15th St Laramie, WY - 820722343 |
Business Phone Number: | 3077426222 |
Business Fax Number: | 3077429905 |
Mailing Address: | 1277 N 15th St, LARAMIE |
State: | WY |
Postal Code: | 820722343 |
Phone Number: | 3077426222 |
Fax Number: | 3077429905 |
NPI Enumeration Date: | 08/03/2011 |
NPI Last Update Date: | 08/03/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 548 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |