Individual
DR. MARY E. MATZEDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
20705 W 151ST ST, OLATHE, KS 66061-7222
(913) 972-5179
Mailing address
8303 TOMASHAW ST, LENEXA, KS 66219-1571
(913) 972-5179
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
882
KS
103T00000X
Psychologist
R0380
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200441610A
—
KS
Enumeration date
01/18/2007
Last updated
10/22/2011
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