| Doctor Name: | DR. ORETHEA YONTONNA MATTISON |
| NPI Number: | 1205110137 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | D.M., L.C.A.D.C. |
| License Number: | LCA346 |
| Business Practice Address: | 7480 Catterick Ct Windsor Mill, MD - 212445600 |
| Business Phone Number: | 4432262838 |
| Business Fax Number: | |
| Mailing Address: | 7480 Catterick Ct, WINDSOR MILL |
| State: | MD |
| Postal Code: | 212445600 |
| Phone Number: | 4432262838 |
| Fax Number: | |
| NPI Enumeration Date: | 10/11/2011 |
| NPI Last Update Date: | 10/11/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | LCA346 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |