Provider Demographics
NPI:1093084725
Name:MATOS, ANITA (BS,CADC)
Entity Type:Individual
Prefix:MS
First Name:ANITA
Middle Name:
Last Name:MATOS
Suffix:
Gender:F
Credentials:BS,CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 N ORANGE ST
Mailing Address - Street 2:2ND FL
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-2296
Mailing Address - Country:US
Mailing Address - Phone:302-656-4044
Mailing Address - Fax:302-656-3439
Practice Address - Street 1:625 N ORANGE ST
Practice Address - Street 2:2ND FL
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-2296
Practice Address - Country:US
Practice Address - Phone:302-656-4044
Practice Address - Fax:302-656-3439
Is Sole Proprietor?:No
Enumeration Date:2011-12-27
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)