Provider Information for 1235649898
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MATTHEW CARLETON LLMSW
Sex: Male
NPI: 1235649898
Last Updated: 2017-10-09
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1235649898 | ||||||||
| Enumeration Date | 2017-10-09 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 27188 ROBIN DR CHESTERFIELD, MI 48051-3191 United States Phone: 586-980-2464 | Fax: | ||||||||
| Primary Practice Address | 2 CROCKER BLVD STE 101 MOUNT CLEMENS, MI 48043-2558 United States Phone: 586-468-2266 | Fax:586-468-4505 | ||||||||
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