Individual
MRS. ANTOINETTE LISA MATTERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
134 W 26TH ST RM 602, NEW YORK, NY 10001-6803
(212) 604-9360
Mailing address
134 W 26TH ST RM 602, NEW YORK, NY 10001-6803
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
07/10/2018
Last updated
07/10/2018
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