Individual
MIA MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PEER SUPPORT SPECIAL
Contact information
Practice address
1121 E MCNICHOLS RD, DETROIT, MI 48203-2857
(313) 365-3100
(313) 365-3101
Mailing address
6685 LARK ST, DETROIT, MI 48213-2300
(313) 687-3965
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
08/31/2021
Last updated
08/31/2021
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