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Individual
MATTHEW WHITAKER
Active
Individual
MATTHEW WHITAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7765
LA
171M00000X
Case Manager/Care Coordinator
PLC7765
LA
Other
Enumeration date
05/13/2019
Last updated
09/08/2021
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