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1295941839
MICHELLE LAUREN MATA
POMONA, CA
NPI
1295941839
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: CA ASW 12000)
Enumeration Date
2007-05-14
Last Update Date
2007-07-08
Business Address
-- MICHELLE LAUREN MATA MSW
2008 N GAREY AVE
POMONA, CA 91767-2722
Phone number: 909-623-6131
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Mailing Address
-- MICHELLE LAUREN MATA MSW
4273 FOXRUN DRIVE
CHINO HILLS, CA 91709
Phone number: 909-606-5608
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