Individual
RACHEL MATTALINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
230 E BROADWAY, LOUISVILLE, KY 40202-2026
(502) 629-8990
(502) 394-3604
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 588-9490
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
252956
KY
1041C0700X
Clinical Social Worker
7035
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300047356
—
IN
05
—
7100502820
—
KY
01
—
K257342
KY MEDICARE
KY
Enumeration date
06/02/2015
Last updated
09/21/2022
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