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Organization

TESSA MATZEN, LCSW LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TESSA MATZEN LCSW (CEO)
(307) 721-4988
Entity
Organization

Contact information

Practice address
121 E GRAND AVE STE 209, LARAMIE, WY 82070-3652
(307) 761-4988
Mailing address
PO BOX 982, LARAMIE, WY 82073-0982
(307) 761-4988

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1447792593
NPI
Enumeration date
04/26/2021
Last updated
04/26/2021
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