Healthcare Provider Details

I. General information

NPI: 1629994769
Provider Name (Legal Business Name): NATALIA MATTEO AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4325 LAKE BOONE TRL STE 305
RALEIGH NC
27607-7510
US

IV. Provider business mailing address

4325 LAKE BOONE TRL STE 305
RALEIGH NC
27607-7510
US

V. Phone/Fax

Practice location:
  • Phone: 984-215-6590
  • Fax: 984-364-2485
Mailing address:
  • Phone: 984-215-6590
  • Fax: 984-364-2485

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number30005222
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: