| Doctor Name: | ELLEN FOSTER MATTINGLY |
| NPI Number: | 1144464207 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S., CCC-SLP |
| License Number: | SA6347 |
| Business Practice Address: | 6295 Lake Worth Road Suite 21 Lake Worth, FL - 334632909 |
| Business Phone Number: | 5616415757 |
| Business Fax Number: | 5616410274 |
| Mailing Address: | 6295 Lake Worth Road, Suite 21 LAKE WORTH |
| State: | FL |
| Postal Code: | 334632909 |
| Phone Number: | 5616415757 |
| Fax Number: | 5616410274 |
| NPI Enumeration Date: | 04/20/2009 |
| NPI Last Update Date: | 11/28/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SA6347 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |