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NPI Code Detail

MEDICARE: DR. CARRIE ELIZABETH MATHEWS PSYD

MEDICARE:  DR. CARRIE ELIZABETH MATHEWS  PSYD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist0810003596VA

General Provider Information

NPI Number : 1043450877
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CARRIE ELIZABETH MATHEWS PSYD
Provider Business Mailing Address
First Line : 2373 MADISON AVE
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23455
Country : US
Telephone Number : 757-652-9177
Fax Number :
Provider Business Practice Location Address
First Line : 2373 MADISON AVE
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23455
Country : US
Telephone Number : 757-652-9177
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2009
Last Update Date : 03/06/2009

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Directions to “ DR. CARRIE ELIZABETH MATHEWS PSYD” Practice Location

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