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Organization
SOMATIC REVELATIONS, LLC
Active
Organization
SOMATIC REVELATIONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TYLER S. TEDMON-JONES PHD (PROVIDER/OWNER)
(307) 200-9228
Entity
Organization
Contact information
Practice address
2020 E GRAND AVE STE 421 & 412, LARAMIE, WY 82070-4370
(307) 200-9228
(307) 460-9084
Mailing address
PO BOX 594, LARAMIE, WY 82073-0594
(307) 200-9228
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
225600000X
Dance Therapist
—
—
Other
Enumeration date
06/29/2020
Last updated
01/07/2025
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