Individual
MARYTERE MATEO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APC
Contact information
Practice address
1281 BARBER CREEK RD, STATHAM, GA 30666-3109
(803) 479-1576
Mailing address
1281 BARBER CREEK RD, STATHAM, GA 30666-3109
(803) 479-1576
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
APC006194
GA
101YM0800X
Mental Health Counselor
APC006194
GA
101YP2500X
Professional Counselor
Primary
APC006194
GA
Other
Enumeration date
11/11/2019
Last updated
11/11/2019
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