MS. Carlene Mattimore, M.S., L.C. P.C.
NPI #1063562361 in Springfield, Illinois
Provider Information
- NPI Number
- 1063562361
- Entity Type
- Individual
- Name
- MS. Carlene Mattimore, M.S., L.C. P.C.
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Counselor - Professional
- Credential
- M.S., L.C. P.C.
- Enumeration Date
- Jan 11, 2007
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 1711 S 5TH ST
- City
- Springfield
- State
- Illinois
- ZIP Code
- 62703-3116
- Phone
- (217) 788-5244
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Professional — Professional |
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