Individual
KATY ANN MATTERN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LABA
Contact information
Practice address
4921 S WENAS RD, SELAH, WA 98942-9000
(509) 951-5022
Mailing address
4921 S WENAS RD, SELAH, WA 98942-9000
(509) 951-5022
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
AB60829120
WA
Other
Enumeration date
02/12/2018
Last updated
02/12/2018
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