Healthcare Provider Details

I. General information

NPI: 1881520534
Provider Name (Legal Business Name): AMANDA MATTEI AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 W FOREST AVE STE 305
FLAGSTAFF AZ
86001-1481
US

IV. Provider business mailing address

77 W FOREST AVE STE 201
FLAGSTAFF AZ
86001-1483
US

V. Phone/Fax

Practice location:
  • Phone: 928-773-2222
  • Fax:
Mailing address:
  • Phone: 928-773-2222
  • Fax: 928-773-2598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberDA17472
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberDA17472
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: