Individual
THEODORE ADAM MATHENY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
203 SWEETBRIAR AVE, CRIDERSVILLE, OH 45806-2293
(740) 407-0757
Mailing address
203 SWEETBRIAR AVE, CRIDERSVILLE, OH 45806-2293
(740) 407-0757
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
—
—
Other
Enumeration date
08/07/2019
Last updated
08/07/2019
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