Provider Demographics
NPI:1710157441
Name:WACHEN, ROBERT MATTHEW (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MATTHEW
Last Name:WACHEN
Suffix:
Gender:M
Credentials:PHD
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Mailing Address - Street 1:200 SPRINGS RD
Mailing Address - Street 2:EDITH NOURSE ROGERS MEMORIAL VETERANS HOSPITAL (116B)
Mailing Address - City:BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01730-1114
Mailing Address - Country:US
Mailing Address - Phone:781-983-3741
Mailing Address - Fax:781-687-2092
Practice Address - Street 1:200 SPRINGS RD
Practice Address - Street 2:EDITH NOURSE ROGERS MEMORIAL VETERANS HOSPITAL (116B)
Practice Address - City:BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:01730-1114
Practice Address - Country:US
Practice Address - Phone:781-983-3741
Practice Address - Fax:781-687-2092
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-10
Last Update Date:2011-02-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA9267103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical