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Individual

JESSICA R. MATTINGLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
307 BOATNER RD STE 114, EGLIN AFB, FL 32542-1302
(210) 292-5838
Mailing address
307 BOATNER RD STE 114, EGLIN AFB, FL 32542-1302

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
110323
TX

Other

Enumeration date
08/17/2023
Last updated
09/03/2024
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