Individual
MRS. PATTY JEAN MATTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
1025 N COUNTRY CLUB DR, MESA, AZ 85201-3307
(480) 472-0734
(480) 472-0892
Mailing address
8055 E ECHO CANYON ST, MESA, AZ 85207-7185
(480) 777-5907
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP0143
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
580044
—
AZ
01
—
SLP0143
DHS LICENSE SLP
AZ
Enumeration date
12/12/2006
Last updated
07/08/2007
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