Individual
LISA MATTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
520 SUPERIOR ST, PORT HURON, MI 48060-3838
(810) 984-4202
Mailing address
520 SUPERIOR ST, PORT HURON, MI 48060-3838
(810) 984-4202
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401006735
MI
Other
Enumeration date
06/09/2021
Last updated
06/09/2021
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