Individual
DR. SARA G MATTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
573 MAIN ST, SUITE 1, WINCHESTER, MA 01890-2900
(781) 729-5655
Mailing address
573 MAIN ST, SUITE 1, WINCHESTER, MA 01890-2900
(781) 729-5655
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
7369
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W05734
BLUE CROSS PROVIDER ID
MA
Enumeration date
01/03/2007
Last updated
07/08/2007
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