Individual
AMY M MATOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
180 CORLISS ST STE B, PROVIDENCE, RI 02904-2602
(401) 793-8400
(401) 793-8402
Mailing address
180 CORLISS ST STE B, PROVIDENCE, RI 02904-2602
(401) 793-8400
(401) 793-8402
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
ISW02662
RI
Other
Enumeration date
09/27/2013
Last updated
05/05/2021
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