Doctor Name: | PATRICIA JOAN MATTOX-LARSON |
NPI Number: | 1144564402 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. CCC-SP |
License Number: | 0320 |
Business Practice Address: | 1251 White Mountain Hwy North Conway, NH - 038605154 |
Business Phone Number: | 6033567294 |
Business Fax Number: | |
Mailing Address: | 1251 White Mountain Hwy, NORTH CONWAY |
State: | NH |
Postal Code: | 038605154 |
Phone Number: | 6033567294 |
Fax Number: | |
NPI Enumeration Date: | 11/26/2012 |
NPI Last Update Date: | 11/26/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 0320 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NH |
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 |