| Doctor Name: | JENNIFER HYRA MATTHIEU |
| NPI Number: | 1013020692 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | C003741 |
| Business Practice Address: | 602 E Academy St Suite 205 Fuquay Varina, NC - 275262302 |
| Business Phone Number: | 9193465357 |
| Business Fax Number: | 9193465356 |
| Mailing Address: | Po Box 310, WILLOW SPRING |
| State: | NC |
| Postal Code: | 275920310 |
| Phone Number: | 9193465357 |
| Fax Number: | 9193465356 |
| NPI Enumeration Date: | 08/16/2006 |
| NPI Last Update Date: | 07/30/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | C003741 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |