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Individual

LEE ANN MAE MATEFFY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR L

Contact information

Practice address
3915 GOLDEN VALLEY ROAD, COURAGE CENTER, GOLDEN VALLEY, MN 55422-4298
(763) 520-0431
(763) 520-0355
Mailing address
3915 GOLDEN VALLEY ROAD, COURAGE CENTER, GOLDEN VALLEY, MN 55422-4298
(763) 520-0431
(763) 520-0355

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
100553
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
048G1HO
BCBS MINNESOTA
01
6404024
MEDICA
01
HP41229
HEALTH PARTNERS
Enumeration date
05/12/2006
Last updated
03/26/2013
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