Provider Demographics
NPI:1073645842
Name:DAILEY, MATTHEW EDMUND (PHD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:EDMUND
Last Name:DAILEY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:699 WASHINGTON ST
Mailing Address - Street 2:STE 101
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-2260
Mailing Address - Country:US
Mailing Address - Phone:908-813-2455
Mailing Address - Fax:908-813-2403
Practice Address - Street 1:699 WASHINGTON ST
Practice Address - Street 2:STE 101
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-2260
Practice Address - Country:US
Practice Address - Phone:908-813-2455
Practice Address - Fax:908-813-2403
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2020-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00396000103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist