Individual
MATTHEW MATTESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
322 N MAIN ST, KOKOMO, IN 46901-4622
(765) 453-8555
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34008689A
IN
Other
Enumeration date
11/04/2019
Last updated
12/01/2020
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