Individual
MS. CHRISTINA M MATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Contact information
Practice address
140 MAIN ST, SUITE 300, NORTHAMPTON, MA 01060-3123
(413) 585-1004
Mailing address
254 LINCOLN AVE, AMHERST, MA 01002-2034
(413) 549-6965
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
111632
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1859722
—
MA
Enumeration date
12/11/2006
Last updated
07/09/2007
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