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NPI Code Detail

MEDICARE: KATHRYN MATTESON LPC

MEDICARE:   KATHRYN  MATTESON  LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor68896TX

General Provider Information

NPI Number : 1346631850
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN MATTESON LPC
Provider Business Mailing Address
First Line : 17511 CYPRESS GLEN ST
Second Line :
City : CYPRESS
State : TX
Zip : 77429-1245
Country : US
Telephone Number : 281-702-5097
Fax Number :
Provider Business Practice Location Address
First Line : 8575 PITNER RD
Second Line :
City : HOUSTON
State : TX
Zip : 77080-2010
Country : US
Telephone Number : 713-462-6565
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2015
Last Update Date : 05/18/2022

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Directions to “ KATHRYN MATTESON LPC” Practice Location

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