Provider Demographics
NPI:1891489514
Name:MATRESCENCE OCCUPATIONAL THERAPY, LLC
Entity type:Organization
Organization Name:MATRESCENCE OCCUPATIONAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER/OCCUPATIONAL THERAPST
Authorized Official - Prefix:MRS
Authorized Official - First Name:GAYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWEE
Authorized Official - Suffix:
Authorized Official - Credentials:OTR, MOT, PMH-C
Authorized Official - Phone:832-661-2695
Mailing Address - Street 1:19701 MOORLYNCH AVE
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-3461
Mailing Address - Country:US
Mailing Address - Phone:832-661-2695
Mailing Address - Fax:
Practice Address - Street 1:1900 STEAMBOAT SPRINGS CV
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-7612
Practice Address - Country:US
Practice Address - Phone:737-235-7730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-06
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty