Individual
MR. MATTHEW DAVID BERTAGNOLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
2417 E 15TH ST, CASPER, WY 82609-2942
(307) 247-1168
Mailing address
4921 RIMROCK DR, BAR NUNN, WY 82601-7703
(307) 247-1168
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-1329
WY
Other
Enumeration date
08/21/2012
Last updated
03/19/2013
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