Individual
TIMOTHY J MATTESON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
55 HOPE ST, PROVIDENCE, RI 02906-2001
(401) 331-1350
Mailing address
55 HOPE ST, PROVIDENCE, RI 02906-2001
(401) 331-1350
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW02182
RI
Other
Enumeration date
04/13/2021
Last updated
04/13/2021
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