Individual
LISA MATAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3120 W MARKET ST, WARREN, OH 44485-3069
(330) 898-6992
Mailing address
535 MARMION AVE, YOUNGSTOWN, OH 44502-2323
(330) 782-5664
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C0900287
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0803312
—
OH
Enumeration date
03/02/2012
Last updated
03/02/2012
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