Organization
DIRTY SOUTH THERAPEUTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL RAY MATHUEWS JR. LISW-S (OWNER/PROVIDER)
(740) 701-2890
Entity
Organization
Contact information
Practice address
77 E WATER ST STE 217, CHILLICOTHE, OH 45601-2586
(740) 701-2890
Mailing address
77 E WATER ST STE 217, CHILLICOTHE, OH 45601-2586
(740) 701-2890
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
172V00000X
Community Health Worker
—
—
Other
Enumeration date
02/07/2024
Last updated
02/07/2024
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