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Individual
JESSICA MATISOFF
Active
Individual
JESSICA MATISOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
77601
TX
101YM0800X
Mental Health Counselor
76701
TX
101YM0800X
Mental Health Counselor
77601
TX
101YP2500X
Professional Counselor
Primary
77601
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
77601
JESSICA MATISOFF
TX
Enumeration date
03/13/2018
Last updated
03/13/2018
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