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Individual

MS. SANDRA LEE MATTSON EBELTOFT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ED.S.

Contact information

Practice address
12606 E. MAIN ST., MAYER, AZ 86333
(928) 642-1010
(928) 632-4005
Mailing address
1950 LAZY MEADOW LN, PRESCOTT, AZ 86303-5044
(928) 445-0121
(928) 541-9043

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary

Other

Enumeration date
04/20/2007
Last updated
07/08/2007
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