Stefanie Mattson

Individual provider Active NPI Physical Rehabilitation Occupational Therapist · Saint Ignace, MI

NPI 1356845663 · NPPES record last updated Mar 21, 2018

Key facts

NPI
1356845663
Entity type
Individual (NPI type 1)
Primary specialty
Physical Rehabilitation Occupational Therapist 225XP0019X
License
5201006338 (MI)
Practice address
1140 N State St
Saint Ignace, MI 49781-1048
Phone
(906) 643-0450
NPI assigned
Mar 21, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
5201006338MIMDPhysical Rehabilitation Occupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Rehabilitation Occupational Therapist
Group: 193400000X SINGLE SPECIALTY GROUP
225XP0019X 5201006338 MI Yes

Addresses

Primary practice location

1140 N State St
Saint Ignace, MI 49781-1048

Mailing address

1140 N State St
Saint Ignace, MI 49781-1048
Phone (906) 643-0450

Other providers in Saint Ignace, MI

All providers in Saint Ignace, MI · Physical Rehabilitation Occupational Therapist in Michigan

Sources for this page

Verify at the official NPI Registry.