Provider Demographics
NPI:1376965046
Name:MATTHEWS, REBECCA ELAINE
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:ELAINE
Last Name:MATTHEWS
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 1:1901 N HARRISON AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-2410
Mailing Address - Country:US
Mailing Address - Phone:919-677-0101
Mailing Address - Fax:919-677-0113
Practice Address - Street 1:1901 N HARRISON AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-2410
Practice Address - Country:US
Practice Address - Phone:919-677-0101
Practice Address - Fax:919-677-0113
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-14
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4554103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist