Provider Demographics
NPI:1679142665
Name:MATTON, TORI
Entity Type:Individual
Prefix:
First Name:TORI
Middle Name:
Last Name:MATTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:539 PAW PAW COVE CT
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-6523
Mailing Address - Country:US
Mailing Address - Phone:703-402-1551
Mailing Address - Fax:
Practice Address - Street 1:539 PAW PAW COVE CT
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-6523
Practice Address - Country:US
Practice Address - Phone:703-402-1551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical