Individual
KALYN L MATTIS VI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2602 QUEEN ANNE CT, ATLANTA, GA 30350-6300
(404) 759-0707
Mailing address
2602 QUEEN ANNE CT, ATLANTA, GA 30350-6300
(404) 759-0707
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
172V00000X
Community Health Worker
—
—
Other
Enumeration date
07/16/2019
Last updated
07/16/2019
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