Provider Demographics
NPI:1629114764
Name:MATTHIAS, MAREN JENNIE
Entity Type:Individual
Prefix:MS
First Name:MAREN
Middle Name:JENNIE
Last Name:MATTHIAS
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 1:28 INMAN ST
Mailing Address - Street 2:APT. 4
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-2415
Mailing Address - Country:US
Mailing Address - Phone:603-661-3325
Mailing Address - Fax:
Practice Address - Street 1:439 S UNION ST
Practice Address - Street 2:SUITE 110
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-2837
Practice Address - Country:US
Practice Address - Phone:978-681-9571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker