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General NPI Number Information
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NPI Number | 1861213647
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Entity Type | Individual
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Provider Name | DANIELA MATZ LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/23/2024
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | 3040 HAMMOND BUSINESS PL # 105
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City | RALEIGH
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State | NC
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Zip | 27603-3666
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Country | US
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Telephone | 919-899-6259
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Fax |
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Provider Business Mailing Address
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Address Line | 202 SWISS LAKE DR
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City | CARY
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State | NC
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Zip | 27513-4792
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Country | US
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Telephone | 217-979-3004
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C011962
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License Number State | NC
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