Provider Demographics
NPI:1851434351
Name:MATSON, JANET P (MS,OTR/L)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:P
Last Name:MATSON
Suffix:
Gender:F
Credentials:MS,OTR/L
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:P
Other - Last Name:MESSERSMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS,OTR/L
Mailing Address - Street 1:167 HAWKINS RD
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TN
Mailing Address - Zip Code:38570-2229
Mailing Address - Country:US
Mailing Address - Phone:570-721-0097
Mailing Address - Fax:
Practice Address - Street 1:167 HAWKINS RD
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TN
Practice Address - Zip Code:38570-2229
Practice Address - Country:US
Practice Address - Phone:570-721-0097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOT3656225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist