Individual
NICHOLE MATTIX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
QMHS 3YR CMS
Contact information
Practice address
1199 DELAWARE AVENUE, MARION, OH 43302
(440) 260-8300
Mailing address
434 EASTLAND ROAD, BEREA, OH 44017
(440) 234-2006
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
OH
251S00000X
Community/Behavioral Health Agency
Primary
—
OH
Other
Enumeration date
10/14/2019
Last updated
10/14/2019
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