Individual
MRS. LISA ANN MATTINGLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
200 NORTHPOINTE CIR, SEVEN FIELDS, PA 16046-7861
(610) 925-4253
Mailing address
311 MARSH OAKS DR, WILMINGTON, NC 28411-8709
(910) 612-1816
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
8817
NC
Other
Enumeration date
09/12/2013
Last updated
09/12/2013
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