Provider Demographics
NPI:1114389061
Name:SWEET, MATTHEW (MA CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:
Last Name:SWEET
Suffix:
Gender:M
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 12TH AVE N STE 10W
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-7503
Mailing Address - Country:US
Mailing Address - Phone:406-237-7000
Mailing Address - Fax:
Practice Address - Street 1:2900 12TH AVE N STE 10W
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-7503
Practice Address - Country:US
Practice Address - Phone:406-237-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-21
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTSLP-SP-LIC-5801235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist