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General NPI Number Information
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NPI Number | 1215688841
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Entity Type | Individual
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Provider Name | MATTHEW E ONAK MA SPP, CMHC INTERN
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Gender | Male
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Dates
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Enumeration Date | 01/14/2022
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Last Update Date | 01/14/2022
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Provider Practice Location Address
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Address Line | 10320 W MCDOWELL RD BUILDING BUILDING G SUITE 7022
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City | AVONDALE
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State | AZ
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Zip | 85392
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Country | US
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Telephone | 760-889-0134
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Fax |
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Provider Business Mailing Address
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Address Line | 12806 W FLOWER ST
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City | AZ - AVONDALE
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State | AZ
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Zip | 85392
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Country | US
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Telephone | 760-889-0134
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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