Kimberlee Ilise Mattingley, BA, SUDCC

NPI #1912553702 in Shingle Springs, California

Provider Information

NPI Number: 1912553702
Entity Type: Individual
Name: Kimberlee Ilise Mattingley, BA, SUDCC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Addiction (Substance Use Disorder)
Credential: BA, SUDCC
Enumeration Date: Aug 16, 2019
Last Updated: Oct 28, 2022

Practice Location

Address: 3974 DUROCK RD STE 205
City: Shingle Springs
State: California
ZIP Code: 95682-8568
Phone: (530) 621-4687

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X	Primary

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