Individual
MRS. SARA ELIZABETH MATLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, CSW
Contact information
Practice address
269 E MAIN ST, PARIS, KY 40361-2126
(859) 253-1686
Mailing address
269 E MAIN ST, PARIS, KY 40361-2126
(859) 253-1686
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790731081
—
KY
Enumeration date
09/04/2014
Last updated
01/19/2016
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