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1245977768
IVAN A MATTHEW
ROCHESTER, NY
NPI
1245977768
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NY 084938)
Enumeration Date
2022-05-16
Last Update Date
2022-05-16
Business Address
IVAN A MATTHEW LCSW
223 MYSTIC LN
ROCHESTER, NY 14623-5448
Phone number: 585-576-4830
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Mailing Address
IVAN A MATTHEW LCSW
223 MYSTIC LANE
ROCHESTER, NY 14623-5448
Phone number: 585-576-4830
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