Provider Demographics
NPI:1295306421
Name:MATTHEWS, JENNIFER REEDER (LPA, HSP-PA)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:REEDER
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:LPA, HSP-PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1716 LAKE GLEN DR
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-6949
Mailing Address - Country:US
Mailing Address - Phone:919-412-7516
Mailing Address - Fax:
Practice Address - Street 1:103 BRADY CT
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-4574
Practice Address - Country:US
Practice Address - Phone:919-465-2550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service