Provider Demographics
NPI:1871805838
Name:O'BRIEN, MATTHEW J (PHD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:J
Last Name:O'BRIEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HAWKINS DR
Mailing Address - Street 2:CENTER FOR DISABILITIES AND DEVELOPMENT, 357
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1016
Mailing Address - Country:US
Mailing Address - Phone:319-353-6444
Mailing Address - Fax:
Practice Address - Street 1:100 HAWKINS DR
Practice Address - Street 2:CENTER FOR DISABILITIES AND DEVELOPMENT
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1016
Practice Address - Country:US
Practice Address - Phone:319-353-6444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-07
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent