Individual
TRACEY NICOLE TEDDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSW
Contact information
Practice address
1263 N 15TH ST, LARAMIE, WY 82072-2343
(307) 674-4405
Mailing address
302 STAMPEDE ST, NEWCASTLE, WY 82701-3037
(423) 845-0391
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
PCSW-1237
WY
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
03/12/2025
Last updated
06/20/2025
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