Individual
MATTHEW MATHENY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
514 1/2 CHESTNUT ST, ROCKFORD, IL 61102-2265
(313) 495-6503
Mailing address
514 1/2 CHESTNUT ST, ROCKFORD, IL 61102-2265
(313) 495-6503
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150014269
IL
104100000X
Social Worker
6801096221
MI
Other
Enumeration date
08/18/2015
Last updated
08/18/2015
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