Provider Demographics
NPI:1366175580
Name:HAND, MATTHEW MARLIN (PHD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:MARLIN
Last Name:HAND
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 1:9133 ASKEW ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-6040
Mailing Address - Country:US
Mailing Address - Phone:254-722-7468
Mailing Address - Fax:
Practice Address - Street 1:9133 ASKEW ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-6040
Practice Address - Country:US
Practice Address - Phone:254-722-7468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36948103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling