Individual
TAMMY LYNN MATTINGLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2894 SAM BROWNING RD, LEBANON, KY 40033-9114
(270) 402-5601
Mailing address
2894 SAM BROWNING RD, LEBANON, KY 40033-9114
(270) 402-5601
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/25/2012
Last updated
12/09/2015
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