Individual
MRS. JESSICA NICOLE MATALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LGSW
Contact information
Practice address
509 LAKE ST, MORGANTOWN, WV 26505-3312
(304) 685-8967
Mailing address
509 LAKE ST, MORGANTOWN, WV 26505-3312
(304) 685-8967
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
BP00944408
WV
104100000X
Social Worker
SW129846
—
Other
Enumeration date
09/04/2012
Last updated
01/16/2015
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