Individual
MS. ELLICE LYNN MATZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
493 FOUNTAIN ST, NEW HAVEN, CT 06515-1830
(518) 233-1152
Mailing address
493 FOUNTAIN STREET, NEW HAVEN, CT 06515-1830
(203) 387-0270
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
002299
CT
1041C0700X
Clinical Social Worker
R0182851
NY
Other
Enumeration date
07/11/2007
Last updated
07/11/2007
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