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General NPI Number Information
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NPI Number | 1457192643
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Entity Type | Organization
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Legal Business Name | PSYCH MATTER PLLC
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 2130 E 2200 N
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City | LAYTON
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State | UT
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Zip | 84040
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Country | US
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Telephone | 801-663-1929
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Fax | 877-559-3988
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Provider Business Mailing Address
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Address Line | 2130 E 2200 N
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City | LAYTON
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State | UT
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Zip | 84040
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Country | US
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Telephone | 801-663-1929
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Fax | 877-559-3988
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Authorized Official
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Title or Position | FOUNDER/OWNER
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Name | BRAUN CONRAD TUELLER
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Credential | DMS, CAQ-PSY, PA-C
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Telephone | 801-663-1929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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