Bongo, Caroljean
Bongo, Caroljean is an sole proprietor health care provider with primary practice located at 2909 Bent Ave , Cheyenne WY 82001-2742. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Bongo, Caroljean can be contacted via phone (307) 760-1871.Contact Information
Primary practice address
2909 Bent Ave
Cheyenne WY 82001-2742
Phone: (307) 760-1871
Fax: (866) 621-1893
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 432 | Wyoming |
Profile Details
| NPI number | 1134220189 |
|---|---|
| LBN Legal business name | Bongo, Caroljean |
| Credentials | PSYD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 25th, 2006 |
| Last updated | Jul 21st, 2022 - about 3 years 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134220189 | NPPES |
| Wyoming | MEDICAID | 124350100 |
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