Individual
REINALDO MATIAS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
203 W FRANCISCAN DR, CROWN POINT, IN 46307-4802
(219) 661-5100
Mailing address
4860 ROBB ST, SUITE 201, WHEAT RIDGE, CO 80033-2184
(303) 278-7418
(888) 341-5050
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20041114A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000235667
ANTHEM
IN
05
—
200105900B
—
IN
01
—
680012369
RAILROAD
IN
Enumeration date
06/15/2006
Last updated
10/08/2013
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