Individual
MRS. MATTRACEA WENDLETON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
900 E SAN MARTIN ST, BOLIVAR, MO 65613-2893
(417) 501-9722
Mailing address
900 E SAN MARTIN ST, BOLIVAR, MO 65613-2893
(417) 501-9722
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2017037738
MO
172V00000X
Community Health Worker
—
—
Other
Enumeration date
10/29/2014
Last updated
05/03/2021
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