Individual
MISS MIKEL ANN MATTICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
411 SWAGGERTOWN RD, SCOTIA, NY 12302-3918
(518) 382-2074
Mailing address
411 SWAGGERTOWN RD, SCOTIA, NY 12302-3918
(518) 382-2074
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0073671
NY
Other
Enumeration date
10/08/2009
Last updated
10/08/2009
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