Provider Information for 1013341601
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Mrs. KRISTINA NICHOL MATTINGLY MSW
Sex: Female
NPI: 1013341601
Last Updated: 2025-01-09
Certification Date: 2025-01-09
Certification Date: 2025-01-09
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1013341601 | ||||||||||||
| Enumeration Date | 2013-08-30 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | PO BOX 3276 EVANSVILLE, IN 47731-3276 United States Phone: 812-473-0181 | Fax:812-492-6498 | ||||||||||||
| Primary Practice Address | 2704 WASHINGTON AVE STE 2 VINCENNES, IN 47591-3668 United States Phone: 812-615-9208 | Fax: | ||||||||||||
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