Individual
MISS KELLI R MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3814 12TH ST NE, WASHINGTON, DC 20017-2630
(202) 656-9059
Mailing address
5577 VINCENT GATE TER UNIT 1220, ALEXANDRIA, VA 22312-2578
(832) 477-7586
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/15/2020
Last updated
09/15/2020
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