Provider Demographics
NPI:1811364276
Name:MATTHEW, NESLYN
Entity type:Individual
Prefix:
First Name:NESLYN
Middle Name:
Last Name:MATTHEW
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4721 NE 66TH AVE APT 30
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-2462
Mailing Address - Country:US
Mailing Address - Phone:857-406-6461
Mailing Address - Fax:
Practice Address - Street 1:14115 ASH MOUNTAIN LN
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77384-2507
Practice Address - Country:US
Practice Address - Phone:936-577-7766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-01
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health