Individual
KRISTA MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
TLLP, LLPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401012458
MI
103TC0700X
Clinical Psychologist
6401012458
MI
Other
Enumeration date
12/05/2011
Last updated
02/22/2021
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