Individual
MR. MATTHEW D. WEATHERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PLPC
Contact information
Practice address
440 S MARKET AVE, SPRINGFIELD, MO 65806-2026
(417) 865-5581
Mailing address
2625 E STANFORD ST, SPRINGFIELD, MO 65804-2040
(417) 770-4404
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2010005419
MO
Other
Enumeration date
03/10/2010
Last updated
10/05/2010
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