Doctor Name: | MS. RHONDA C MATLACK |
NPI Number: | 1104928951 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A LMHC |
License Number: | 3259 |
Business Practice Address: | 14 Cedar St Amesbury, MA - 019131831 |
Business Phone Number: | 9782705647 |
Business Fax Number: | |
Mailing Address: | 5 Glenwood St, AMESBURY |
State: | MA |
Postal Code: | 019131103 |
Phone Number: | 9782705647 |
Fax Number: | |
NPI Enumeration Date: | 09/02/2006 |
NPI Last Update Date: | 01/05/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 3259 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |