Provider Demographics
NPI:1699090456
Name:MATTSON, PAULA HANNEY
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:HANNEY
Last Name:MATTSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 ERDMAN WAY
Mailing Address - Street 2:COMMUNITY HEALTHLINK
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-1804
Mailing Address - Country:US
Mailing Address - Phone:978-840-9389
Mailing Address - Fax:978-840-9389
Practice Address - Street 1:100 ERDMAN WAY
Practice Address - Street 2:COMMUNITY HEALTHLINK
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-1804
Practice Address - Country:US
Practice Address - Phone:978-840-9389
Practice Address - Fax:978-840-9389
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-05
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist