Individual
MR. KEVIN JOSEPH MATAWA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LPC
Contact information
Practice address
450 HIGHLAND AVE, WOOD RIDGE, NJ 07075-1212
(551) 246-1502
Mailing address
450 HIGHLAND AVE, WOOD RIDGE, NJ 07075-1212
(551) 246-1502
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37PC00718300
NJ
Other
Enumeration date
05/13/2020
Last updated
05/13/2020
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