Individual
MS. CARLENE MATTIMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., L.C. P.C.
Contact information
Practice address
1711 S 5TH ST, SPRINGFIELD, IL 62703-3116
(217) 788-5244
(217) 788-1650
Mailing address
1711 S 5TH ST, SPRINGFIELD, IL 62703-3116
(217) 788-5244
(217) 788-1650
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
IL
Other
Enumeration date
01/11/2007
Last updated
07/08/2007
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