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Individual

KYLE G MATZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMFT

Contact information

Practice address
2713 W HARVARD AVE STE 90, ROSEBURG, OR 97471-2600
(541) 430-2096
(541) 637-0849
Mailing address
PO BOX 398, ROSEBURG, OR 97470-0101
(541) 430-2096
(541) 637-0849

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
T0726
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500646717
OR
Enumeration date
03/25/2011
Last updated
09/13/2022
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