Individual
JACQUELINE MATACCHIERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
37LC00279900
NJ
101YP2500X
Professional Counselor
Primary
37PC00585900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
DO SERVE MEDICAID CLIENTS AS OF YET
—
Enumeration date
10/02/2018
Last updated
10/02/2018
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