Individual
MIRISSA BONITA MATHEWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11636 COUNTY FARM RD, AURORA, IN 47001-8758
(812) 926-0110
Mailing address
7941 CASTLEWAY DR, INDIANAPOLIS, IN 46250-1953
(317) 726-2121
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
99122333A
IN
Other
Enumeration date
07/15/2024
Last updated
07/15/2024
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