Individual
BRUCE WILLIS MATTMILLER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MHP
Contact information
Practice address
347 N THIRD ST, ASHLEY, IL 62808-1830
(618) 310-8932
Mailing address
347 N THIRD ST, ASHLEY, IL 62808-1830
(618) 310-8932
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/13/2019
Last updated
09/13/2019
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