Individual
ERIC MATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSW, LCDCIII
Contact information
Practice address
106 E. MAIN ST., SPRINGFIELD, OH 45502
(937) 284-0744
Mailing address
106 E. MAIN ST., SPRINGFIELD, OH 45502
(937) 284-0744
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCDCIII.161754
OH
Other
Enumeration date
04/03/2025
Last updated
04/03/2025
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