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Individual

DEWAYNE ALFRED MATTISON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LLBSW

Contact information

Practice address
28631 THORNAPPLE DR APT 202, SOUTHFIELD, MI 48034-5450
(248) 904-3611
Mailing address
28631 THORNAPPLE DR APT 202, SOUTHFIELD, MI 48034-5450
(248) 904-3611

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Enumeration date
12/28/2020
Last updated
12/28/2020
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