Individual
MR. JENNIFER REBECCA MATTIKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
34 BRENTWOOD RD, CAMP HILL, PA 17011-2506
(717) 730-0511
(717) 730-0511
Mailing address
34 BRENTWOOD RD, CAMP HILL, PA 17011-2506
(717) 730-0511
(717) 730-0511
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL006062L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017858060004
—
PA
Enumeration date
05/22/2007
Last updated
07/09/2007
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