Individual
JESSICA N MATOOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
55 HOPE ST, PROVIDENCE, RI 02906-2001
(401) 331-1350
(401) 277-3366
Mailing address
134 THURBERS AVE, PROVIDENCE, RI 02905-4754
(401) 331-1350
(401) 277-3366
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
CSW01740
RI
Other
Enumeration date
08/09/2013
Last updated
04/14/2015
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