Provider Demographics
NPI:1356980528
Name:MATTHEYER, MACY LEE (COTA/L)
Entity type:Individual
Prefix:
First Name:MACY
Middle Name:LEE
Last Name:MATTHEYER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2712 CANAL BLVD APT 24
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-1752
Mailing Address - Country:US
Mailing Address - Phone:785-769-3263
Mailing Address - Fax:
Practice Address - Street 1:1520 N PLUM ST
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67501-5854
Practice Address - Country:US
Practice Address - Phone:620-615-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-05
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS18-01619224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant