Provider Demographics
NPI:1386385839
Name:MATTEO, BROOKE KATHLEEN (AUD)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:KATHLEEN
Last Name:MATTEO
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:KATHLEEN
Other - Last Name:BAYSINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1648
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97440-1648
Mailing Address - Country:US
Mailing Address - Phone:541-334-3370
Mailing Address - Fax:541-334-3372
Practice Address - Street 1:330 S GARDEN WAY STE 300
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-8185
Practice Address - Country:US
Practice Address - Phone:541-334-3370
Practice Address - Fax:541-334-3372
Is Sole Proprietor?:No
Enumeration Date:2022-04-06
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OR31035231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program