Individual
MATTHEW DAVID WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AAS, PLADC
Contact information
Practice address
2808 N 75TH ST, OMAHA, NE 68134-6861
(402) 932-2248
(402) 932-3557
Mailing address
2808 N 75TH ST, OMAHA, NE 68134-6861
(402) 932-2248
(402) 932-3557
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
P-1013
NE
Other
Enumeration date
03/14/2012
Last updated
03/14/2012
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