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NPI Profile for KELSEY L MAMMEN in CASPER, WY.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X | |||
Health Service |
103TH0100X | 62 | Psychologist, Clinical |
| NPI Number | 1851722482 |
|
| Status | Active | |
| Credentials | PPC | |
| Entity | Individual | |
| Enumeration date | 12/08/2013 | |
| Last updated | 07/12/2022 - About 4 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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KELSEY L MAMMEN
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KELSEY L MAMMEN, PPC