Individual
ITZEL C MATAMOROS SANTOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
19215 SE 34TH ST # 106-220, CAMAS, WA 98607-8829
(414) 369-0137
Mailing address
19215 SE 34TH ST # 106-220, CAMAS, WA 98607-8829
(414) 369-0137
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
22008923A
IN
235Z00000X
Speech-Language Pathologist
Primary
LL61483039
WA
Other
Enumeration date
10/31/2023
Last updated
12/23/2024
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