Individual
DR. MICHELE MATTIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
517 PIERCE ST, SUITE B, KINGSTON, PA 18704-5731
(570) 718-1150
(570) 714-1321
Mailing address
517 PIERCE ST, SUITE B, KINGSTON, PA 18704-5731
(570) 718-1150
(570) 714-1321
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS008609L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2057094
CIGNA
PA
01
—
359151
BC/BS
PA
Enumeration date
07/06/2006
Last updated
07/08/2007
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