Individual
RICOLE MATTHEWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1809 WINDOVER RD, COLUMBIA, SC 29204-1541
(803) 477-7643
Mailing address
1809 WINDOVER RD, COLUMBIA, SC 29204-1541
(803) 477-7643
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
SC
05
—
NA
—
SC
Enumeration date
04/21/2021
Last updated
04/21/2021
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