Individual
MARY MATESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPA
Contact information
Practice address
66 CLUB RD STE 120, EUGENE, OR 97401
(541) 393-5983
(541) 393-5984
Mailing address
66 CLUB RD STE 120, EUGENE, OR 97401-2439
(541) 393-5983
(541) 393-5984
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
103T00000X
Psychologist
Primary
5065
OR
103TB0200X
Cognitive & Behavioral Psychologist
5065
OR
103TM1800X
Intellectual & Developmental Disabilities Psychologist
5065
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500719639
—
OR
Enumeration date
10/27/2009
Last updated
11/27/2024
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