Individual
KENYATTA B MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
312 MILLER ST, LEWISTON, ID 83501-1944
(208) 750-1802
(208) 750-1803
Mailing address
312 MILLER ST, LEWISTON, ID 83501-1944
(208) 750-1802
(208) 750-1803
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
ID
Other
Enumeration date
10/18/2023
Last updated
10/18/2023
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