Provider Demographics
NPI:1689938540
Name:PARIS, MATTHEW VINCENT (PSYD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:VINCENT
Last Name:PARIS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:747 HAMPTON RIDGE DR.
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-0040
Mailing Address - Country:US
Mailing Address - Phone:507-920-2307
Mailing Address - Fax:
Practice Address - Street 1:747 HAMPTON RIDGE DR
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-8138
Practice Address - Country:US
Practice Address - Phone:507-920-2307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-26
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6770103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical