Individual
MS. STACY RIDDLE-MATTOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
152 HIGHWAY 7 S, OXFORD, MS 38655-5392
(662) 234-7521
(662) 236-3071
Mailing address
152 HIGHWAY 7 S, OXFORD, MS 38655-5392
(662) 234-7521
(662) 236-3071
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
MS
101YP2500X
Professional Counselor
Primary
—
MS
104100000X
Social Worker
—
—
Other
Enumeration date
01/11/2012
Last updated
11/19/2021
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