Individual
MICHELLE E MASTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3900 WASHINGTON AVE # 100, EVANSVILLE, IN 47714-0550
(812) 485-6694
Mailing address
3900 WASHINGTON AVE # 100, EVANSVILLE, IN 47714-0550
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
1799
AL
103TC2200X
Clinical Child & Adolescent Psychologist
6301012872
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P108974770
BCBS PERSONAL PIN
MI
Enumeration date
05/18/2006
Last updated
08/29/2024
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