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Individual

DR. IRENE MATIATOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
23 SILVER DARTER LN, BILTMORE LAKE, NC 28715-9526
(551) 206-3762
(828) 633-2143
Mailing address
23 SILVER DARTER LN, BILTMORE LAKE, NC 28715-9526
(551) 206-3762
(828) 633-2143

Taxonomy

Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
010778-1
NY
103TC0700X
Clinical Psychologist
010778-1
NY
103TC0700X
Clinical Psychologist
Primary
3902
NC
103TF0000X
Family Psychologist
010778-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
386523
MVP
NY
01
6802210
GHI
NY
01
P570970
OXFORD
NY
01
S10778
WORKERS COMPENSATION
NY
Enumeration date
11/15/2006
Last updated
09/23/2010
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