Individual
ANGELA RENEE MATSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3314 SORA WAY, BOZEMAN, MT 59718-7345
(406) 581-8440
Mailing address
3314 SORA WAY, BOZEMAN, MT 59718-7345
(406) 581-8440
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
#SP388
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265564520
—
MT
Enumeration date
03/12/2007
Last updated
07/21/2022
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