Provider Demographics
NPI:1255632303
Name:MATTSON, RHONDA CATHERINE (MOTR/L, CHT)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:CATHERINE
Last Name:MATTSON
Suffix:
Gender:F
Credentials:MOTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14500 E 42ND ST S STE 220
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-4700
Mailing Address - Country:US
Mailing Address - Phone:816-478-7800
Mailing Address - Fax:816-478-7839
Practice Address - Street 1:14500 E 42ND ST S STE 220
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055
Practice Address - Country:US
Practice Address - Phone:816-478-7800
Practice Address - Fax:816-478-7839
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-05
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010036935225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist