Individual
KEVIN M. MATTHEWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CCC-SLP
Contact information
Practice address
10 E COLLEGE AVE STE 300, APPLETON, WI 54911-5759
(920) 707-3158
Mailing address
355 E VISTA RIDGE MALL DR APT 5424, LEWISVILLE, TX 75067-4025
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
14068067
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
112011
STATE BOARD OF EXAMINERS FOR SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY
TX
01
—
14068067
AMERICAN SPEECH-LANGUAGE-HEARING ASSOSCIATION
—
Enumeration date
03/15/2018
Last updated
03/15/2018
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