Individual
ANDREA MATTINGLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSP.RN
Contact information
Practice address
2210 TUCKER STATION RD, LOUISVILLE, KY 40299-4525
(502) 366-0705
Mailing address
101 W MUHAMMAD ALI BLVD, LOUISVILLE, KY 40202-1423
(502) 589-8600
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/02/2016
Last updated
01/02/2016
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