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Individual

MRS. BAILEY MATTISON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1841 PARK AVE, NEW YORK, NY 10035-1316
(646) 459-6091
Mailing address
1366 INWOOD AVE, BRONX, NY 10452-3203
(702) 578-3035

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
225400000X
Rehabilitation Practitioner

Other

Enumeration date
08/04/2010
Last updated
08/23/2016
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