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Individual
MR. MATTHEW JOHN DEETS
Active
Individual
MR. MATTHEW JOHN DEETS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1801-226
WI
101YP2500X
Professional Counselor
Primary
5814-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1801-226
STATE LICENSE
WI
01
—
5814-125
STATE LICENSE
WI
Enumeration date
12/29/2014
Last updated
11/04/2015
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