Individual
JEFFREY M. MATHERNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
212 S KALMIA AVE, HIGHLAND SPRINGS, VA 23075-1708
(804) 404-3660
Mailing address
212 S KALMIA AVE, HIGHLAND SPRINGS, VA 23075-1708
(804) 404-3660
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
—
—
Other
Enumeration date
06/08/2022
Last updated
06/08/2022
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