| Doctor Name: | MR. ROBERT MATTIA |
| NPI Number: | 1225137177 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCMHC |
| License Number: | |
| Business Practice Address: | 12 Parmenter Rd Londonderry, NH - 030533280 |
| Business Phone Number: | 6034372069 |
| Business Fax Number: | 6034375588 |
| Mailing Address: | 97 Island Pond Rd, DERRY |
| State: | NH |
| Postal Code: | 030384144 |
| Phone Number: | 6034344335 |
| Fax Number: | |
| NPI Enumeration Date: | 09/21/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |