Individual
MICHAEL MCLANE MATTHEWS
Active
Individual
MICHAEL MCLANE MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CCMA
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
363AM0700X
Medical Physician Assistant
Primary
T7A7N8C3
—
Other
Enumeration date
01/11/2023
Last updated
02/18/2023
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