Provider Demographics
NPI:1235942343
Name:MATTSON, ERIKA MARIE
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:MARIE
Last Name:MATTSON
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 1:955 W CLAIREMONT AVE APT 211
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-6116
Mailing Address - Country:US
Mailing Address - Phone:218-235-7968
Mailing Address - Fax:
Practice Address - Street 1:955 W CLAIREMONT AVE APT 211
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-6116
Practice Address - Country:US
Practice Address - Phone:218-235-7968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer