Individual
RODNEY DEAN MATILAINEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.A.D.C.
Contact information
Practice address
4110 AVE. D, SCOTTSBLUFF, NE 69361
(308) 635-3171
Mailing address
131 MARY LN, SCOTTSBLUFF, NE 69361-3829
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
498
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
498
LICENSED ALCOHOL AND DRUG
NE
Enumeration date
09/05/2006
Last updated
07/08/2007
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