Individual
KELSEY L MAMMEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PPC
Contact information
Practice address
1607 CY AVE STE 102, CASPER, WY 82604-3571
(307) 337-4673
Mailing address
1607 CY AVE STE 102, CASPER, WY 82604-3571
(775) 445-9127
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PPC-1190
WY
103TH0100X
Health Service Psychologist
—
—
Other
Enumeration date
12/08/2013
Last updated
07/12/2022
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