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Individual
MS. PHYLLIS MARIE MATICHAK
Active
Individual
MS. PHYLLIS MARIE MATICHAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCADC PENDING
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCADC PENDING
NJ
101YM0800X
Mental Health Counselor
NOT LICENSED
NJ
Other
Enumeration date
06/17/2008
Last updated
06/17/2008
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