| Michele Mattie, Phd, Llc | |
|
517 Pierce St Suite B Kingston PA 18704-5731 | |
| (570) 718-1150 | |
| (570) 714-1321 |
| Full Name | Michele Mattie, Phd, Llc |
|---|---|
| Speciality | Psychologist - Clinical Child & Adolescent |
| Location | 517 Pierce St, Kingston, Pennsylvania |
| Authorized Official Name and Position | Michele Mattie (OWNER) |
| Authorized Official Contact | 5707181150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michele Mattie, Phd, Llc 517 Pierce St Suite B Kingston PA 18704-5731 Ph: (570) 718-1150 | Michele Mattie, Phd, Llc 517 Pierce St Suite B Kingston PA 18704-5731 Ph: (570) 718-1150 |
| NPI Number | 1477655314 |
|---|---|
| Provider Enumeration Date | 09/01/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477655314 | NPI | - | NPPES |
| 1285665075 | Other | PA | INDIVIDUAL NPI |
| 359151 | Other | PA | BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC2200X | Psychologist - Clinical Child & Adolescent | PS008609L (Pennsylvania) | Primary |
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