Individual
MATTHEW DEAN WHITIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW, MAC
Contact information
Practice address
6600 VAN AALST BLVD BLDG 9250, FORT MOORE, GA 31905-2102
(706) 545-5244
Mailing address
5001 DONNA SUE DR, COLUMBUS, GA 31907-1789
(614) 286-4285
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
9810
SC
Other
Enumeration date
12/28/2011
Last updated
10/17/2024
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