Provider Demographics
NPI:1851449979
Name:MATTESON, PATRICIA ELLEN (NCMT)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ELLEN
Last Name:MATTESON
Suffix:
Gender:F
Credentials:NCMT
Other - Prefix:
Other - First Name:TRISHA
Other - Middle Name:
Other - Last Name:MATTESON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NCMT
Mailing Address - Street 1:2231 CHAROLAIS DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-1407
Mailing Address - Country:US
Mailing Address - Phone:970-420-8040
Mailing Address - Fax:
Practice Address - Street 1:2231 CHAROLAIS DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-1407
Practice Address - Country:US
Practice Address - Phone:970-420-8040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist