Individual
KAILEY BROOKE MATTARELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 PINE ST STE 140, ZEELAND, MI 49464-2603
(616) 748-2166
Mailing address
184 E 7TH ST APT 22, HOLLAND, MI 49423-5715
(231) 631-6085
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6851110521
MI
Other
Enumeration date
08/16/2021
Last updated
08/16/2021
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