Matocha, Theresa Marie

Matocha, Theresa Marie is an sole proprietor health care provider with primary practice located at 3015 Hubbard Ln Ste 7, Eureka CA 95501-4803. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Matocha, Theresa Marie can be contacted via phone (802) 425-8101.

Contact Information

Primary practice address
3015 Hubbard Ln Ste 7 Eureka CA 95501-4803
Phone: (802) 425-8101
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 089.0089650 Vermont
Behavioral Health & Social Service Providers / Clinical 1041C0700X 089.0089650 Vermont

Profile Details

NPI number 1639415300
LBN Legal business name Matocha, Theresa Marie
Credentials LISCW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 27th, 2012
Last updated Nov 10th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1639415300 NPPES
Vermont Other 089.0089650 STATE OF VT

Popular Providers