Individual
MATTHEW MALLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1520 MADISON AVE, FORT ATKINSON, WI 53538-3100
(920) 563-5500
Mailing address
301 CHEROKEE LN, FORT ATKINSON, WI 53538-3006
(608) 322-8553
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7548-123
WI
Other
Enumeration date
02/25/2021
Last updated
10/07/2022
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