Provider Demographics
NPI:1891543435
Name:SCHATZ, MATTIE
Entity type:Individual
Prefix:
First Name:MATTIE
Middle Name:
Last Name:SCHATZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8103 RIDGELAND DR
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-6244
Mailing Address - Country:US
Mailing Address - Phone:701-426-0173
Mailing Address - Fax:
Practice Address - Street 1:4342 15TH AVE S STE 105
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-1125
Practice Address - Country:US
Practice Address - Phone:701-936-9495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-08
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician