Deitrich-Maclean, Vivian Gay

Deitrich-Maclean, Vivian Gay is an individual health care provider with primary practice located at 507 S 4Th St Suite B, Laramie WY 82070-3729. She recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Family. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Deitrich-Maclean, Vivian Gay can be contacted via phone (307) 755-1982.

Contact Information

Primary practice address
507 S 4Th St Suite B Laramie WY 82070-3729
Phone: (307) 755-1982
Fax: (307) 742-4089
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 291 Wyoming
Behavioral Health & Social Service Providers / Psychologist 103T00000X 291 Wyoming
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X 291 Wyoming
Behavioral Health & Social Service Providers / Family 103TF0000X 291 Wyoming

Profile Details

NPI number 1003030511
LBN Legal business name Deitrich-Maclean, Vivian Gay
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 13th, 2007
Last updated Jul 20th, 2024 - about 4 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003030511 NPPES
Wyoming MEDICAID 119587500

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