Individual
DR. TERRENCE M MATTEO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
10616 S 43RD ST, PHOENIX, AZ 85044-1305
(480) 382-4142
Mailing address
10616 S 43RD ST, PHOENIX, AZ 85044-1305
(480) 382-4142
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
AZ3877
AZ
103TM1800X
Intellectual & Developmental Disabilities Psychologist
3877
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
211835
—
AZ
Enumeration date
01/17/2007
Last updated
08/27/2014
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