Individual
LESLIE MATLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
568 PINEWOOD DR, LONGMEADOW, MA 01106-1665
(413) 565-5101
(413) 567-6998
Mailing address
568 PINEWOOD DR, LONGMEADOW, MA 01106-1665
(413) 565-5101
(413) 567-6998
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
001669
CT
103TC0700X
Clinical Psychologist
Primary
6162
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0526053
—
MA
Enumeration date
11/14/2006
Last updated
07/08/2007
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