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Individual
KIRSTEN ARIEL MATALA
Active
Individual
KIRSTEN ARIEL MATALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.168743
OH
104100000X
Social Worker
I.2405731
OH
1041C0700X
Clinical Social Worker
Primary
I.2405731
OH
Other
Enumeration date
03/21/2018
Last updated
08/21/2024
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