| Doctor Name: | WENDY MATIAS |
| NPI Number: | 1386708741 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA |
| License Number: | |
| Business Practice Address: | 5820 Little Neck Pkwy Little Neck, NY - 113622530 |
| Business Phone Number: | 7186312130 |
| Business Fax Number: | |
| Mailing Address: | 2703 Eagle Ave, MEDFORD |
| State: | NY |
| Postal Code: | 117632054 |
| Phone Number: | 6317144360 |
| Fax Number: | |
| NPI Enumeration Date: | 12/20/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |