Individual
MR. JOSE MANUEL MATA III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LMFT-A
Contact information
Practice address
2201 S W S YOUNG DR STE 116A, KILLEEN, TX 76543-5314
(254) 213-3705
Mailing address
2201 S W S YOUNG DR STE 116A, KILLEEN, TX 76543-5314
(254) 213-3705
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
204741
TX
Other
Enumeration date
01/10/2023
Last updated
01/10/2023
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