Individual
REBECCA MARIE MATTAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
480 CENTRAL AVE, PEARL HARBOR, HI 96860-4908
(808) 471-1866
Mailing address
480 CENTRAL AVE, PEARL HARBOR, HI 96860-4908
(808) 471-1866
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
2013-179
CA
Other
Enumeration date
07/17/2013
Last updated
07/17/2013
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