Provider Demographics
NPI:1497889372
Name:ROBINSON, MATTHEW SCOTT (PHD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:SCOTT
Last Name:ROBINSON
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 1:116 DYER AVE
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-1514
Mailing Address - Country:US
Mailing Address - Phone:617-626-9780
Mailing Address - Fax:617-626-9510
Practice Address - Street 1:20 VINING ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6115
Practice Address - Country:US
Practice Address - Phone:617-626-9780
Practice Address - Fax:617-626-9510
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7658103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical