Provider Demographics
NPI:1831500511
Name:HOLCOMB, MATTHEW (PHD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:
Last Name:HOLCOMB
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 1:335 BOG RD
Mailing Address - Street 2:
Mailing Address - City:ENFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:03748-4103
Mailing Address - Country:US
Mailing Address - Phone:662-630-0134
Mailing Address - Fax:
Practice Address - Street 1:335 BOG RD
Practice Address - Street 2:
Practice Address - City:ENFIELD
Practice Address - State:NH
Practice Address - Zip Code:03748-4103
Practice Address - Country:US
Practice Address - Phone:662-630-0134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-15
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist