Individual
MICHELLE M MATTHEWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4109 67TH ST, KENOSHA, WI 53142-3836
(262) 652-9830
(262) 652-2931
Mailing address
3341 N 85TH ST, MILWAUKEE, WI 53222-3708
(414) 837-5227
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7334-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43739800
—
WI
Enumeration date
02/13/2007
Last updated
08/20/2015
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