Individual
MR. THEODORE CHRISTOPHER MATAXIS III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A., L.P.A
Contact information
Practice address
318 N MAIN ST, TROY, NC 27371-3018
(910) 576-1188
(910) 576-1182
Mailing address
7 FUR CT E, PINEHURST, NC 28374-8210
(910) 585-1399
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
2540
NC
103TB0200X
Cognitive & Behavioral Psychologist
2540
NC
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
2540
NC
Other
Enumeration date
03/08/2007
Last updated
09/11/2025
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