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Penny Angel Mata, MEDICALASSISTANT
Speech/Language/Hearing Specialist/Technologist in Caldwell, Idaho
NPI 1518601020

Penny Angel Mata is a Speech/Language/Hearing Specialist/Technologist based in Caldwell, ID. Penny Angel Mata practices in Caldwell, ID and has the professional credentials of MEDICALASSISTANT. The NPI Number for Penny Angel Mata is 1518601020 and holds a License No. (Idaho).

The current practice location address for Penny Angel Mata is 4521 Thomas Jefferson St, Caldwell, ID and can be reached out via phone at 208-454-4820 and via fax at 208-454-4859.

Location: 4521 Thomas Jefferson St, Caldwell, ID, 83605-5100
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1518601020
Provider Name
Penny Angel Mata
Credential
MEDICALASSISTANT
Provider Entity Type
Individual
Gender
Female
Address
4521 Thomas Jefferson St, Caldwell, ID, 83605-5100
Phone Number
208-454-4820
Fax Number
208-454-4859
Provider Enumeration Date
04/21/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
4521 Thomas Jefferson St
City
Caldwell
State
Idaho
Zip
83605-5100
Phone Number
208-454-4820
Fax Number
208-454-4859
person
Provider Business Mailing Address Details
Address
4521 Thomas Jefferson St
City
Caldwell
State
Idaho
Zip
83605-5100
Phone Number
208-454-4820
Fax Number
208-454-4859
person
Provider's Taxonomy Details 1
Type
Speech, Language and Hearing Service Providers
Classification
Specialist/Technologist
Speciality
-
Taxonomy
235500000X
License No.
()
Definition
General classification identifying individuals who are trained on a specific piece of equipment or technical procedure.
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