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Individual

ALYSE MATLOCK WILLETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
100 E SOUTH ST STE 5, CHARLOTTESVILLE, VA 22902-5217
(972) 499-5561
Mailing address
100 E SOUTH ST STE 5, CHARLOTTESVILLE, VA 22902-5217
(972) 499-5561

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701010444
VA
101YP2500X
Professional Counselor
76174
TX

Other

Enumeration date
05/17/2021
Last updated
10/31/2022
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