Individual
CALLIE ANN MATOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC-R
Contact information
Practice address
221 W MAIN ST # 300, MEDFORD, OR 97501-2728
(541) 821-9559
Mailing address
5269 COZY GLEN LN, ALEXANDRIA, VA 22312-3911
(541) 292-8310
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/11/2021
Last updated
05/17/2022
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