MEDICARE: GWENEVERE MATTI

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
1	106H00000X	Marriage & Family Therapist	205722	TX

General Provider Information

NPI Number	:	1851271027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GWENEVERE MATTI

Provider Business Mailing Address
First Line	:	6823 NORTHAMPTON WAY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77055-7618
Country	:	US
Telephone Number	:	713-800-6999
Fax Number	:

Provider Business Practice Location Address
First Line	:	6823 NORTHAMPTON WAY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77055-7618
Country	:	US
Telephone Number	:	713-800-6999
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2025
Last Update Date	:	09/06/2025

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Directions to “ GWENEVERE MATTI ” Practice Location

Language	Start Address	Practice Location

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