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General NPI Number Information
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NPI Number | 1922421072
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Entity Type | Individual
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Provider Name | MATTHEW D. MEARA PH.D.
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Gender | Male
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Dates
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Enumeration Date | 01/27/2014
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Last Update Date | 04/15/2014
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Provider Practice Location Address
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Address Line | 6797 N HIGH ST SUITE 223
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City | WORTHINGTON
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State | OH
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Zip | 43085-2533
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Country | US
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Telephone | 614-902-3811
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Fax |
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Provider Business Mailing Address
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Address Line | 694 FALLSIDE LN
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City | WESTERVILLE
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State | OH
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Zip | 43081-5003
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Country | US
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Telephone | 614-735-2202
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 7046
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License Number State | OH
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