Provider Demographics
NPI:1134769177
Name:MATTHEWS, PAULA ANDREA
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:ANDREA
Last Name:MATTHEWS
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 1:1533 BATFISH CT APT D
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-6721
Mailing Address - Country:US
Mailing Address - Phone:719-229-0339
Mailing Address - Fax:
Practice Address - Street 1:1111 12TH ST STE 212
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-3001
Practice Address - Country:US
Practice Address - Phone:305-783-3677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-07
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor