Individual provider · Type 1 NPI
Kimberlee Ilise Mattingley, BA, SUDCC
Addiction (Substance Use Disorder) Counselor · Shingle Springs, CA
NPI number
1912553702
Active
Practice location
3974 Durock Rd Ste 205
Shingle Springs, CA 95682-8568
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 10848 (CA) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
Another provider at this address
About NPI 1912553702
Kimberlee Ilise Mattingley, BA, SUDCC's National Provider Identifier is 1912553702, issued on Aug 16, 2019. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Shingle Springs, CA. The record was last updated on Oct 28, 2022.