Healthcare Provider Details
I. General information
NPI: 1427339233
Provider Name (Legal Business Name): REBECCA MARIE MATSON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/07/2011
Last Update Date: 09/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7921 SOUTHPARK PLZ SUITE 204
LITTLETON CO
80120-5630
US
IV. Provider business mailing address
7921 SOUTHPARK PLZ SUITE 204
LITTLETON CO
80120-5630
US
V. Phone/Fax
- Phone: 720-489-8555
- Fax: 720-489-8304
- Phone: 720-489-8555
- Fax: 720-489-8304
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | 3082 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: