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Individual
KATIE MATTINGLEY
Active
Individual
KATIE MATTINGLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-SP-LC-1221
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033653761
—
MT
Enumeration date
12/14/2016
Last updated
04/28/2017
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