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General NPI Number Information
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NPI Number | 1689914566
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Entity Type | Individual
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Provider Name | MICHELE LEE MATTIS PSYD
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Gender | Female
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Dates
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Enumeration Date | 02/28/2013
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Last Update Date | 01/29/2026
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Provider Practice Location Address
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Address Line | 100 EXCELA HEALTH DR STE 301
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City | LATROBE
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State | PA
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Zip | 15650-9001
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Country | US
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Telephone | 724-537-1942
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Fax | 724-539-6353
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Provider Business Mailing Address
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Address Line | 100 EXCELA HEALTH DR STE 301
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City | LATROBE
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State | PA
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Zip | 15650-9001
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Country | US
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Telephone | 724-537-1942
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Fax | 724-539-6353
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PS017844
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License Number State | PA
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