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Individual
KRISTIN MATVICHUK
Active
Individual
KRISTIN MATVICHUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLMSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6851114923
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245744994
—
MI
Enumeration date
11/16/2017
Last updated
05/26/2022
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