Individual
DR. MATTHEW WILLIAM JERRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1679 MASSACHUSETTS AVE, CAMBRIDGE, MA 02138-1807
(617) 388-6876
(617) 441-7510
Mailing address
1679 MASSACHUSETTS AVE, CAMBRIDGE, MA 02138-1807
(617) 388-6876
(617) 441-7510
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
8429
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W06387
BLUE CROSS BLUE SHIELD MA
MA
Enumeration date
05/26/2006
Last updated
08/09/2007
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