Individual
ANDREA MATTISEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW BCD
Contact information
Practice address
162 COMMERCIAL ST, BOSTON, MA 02109-1332
(617) 742-2270
(617) 742-2270
Mailing address
162 COMMERCIAL ST, BOSTON, MA 02109-1332
(617) 742-2270
(617) 742-2270
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
101700
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101700
LICENSE
MA
Enumeration date
02/28/2007
Last updated
07/08/2007
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