Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PY7589 | FL |
Y | 103TC0700X | Clinical Psychologist | PY7589 | FL |
NPI | 1003097312 |
---|---|
Provider Name | Aarti Mathur |
First Address | Odessa, FL 33556-2887 |
Second Address | Lutz, FL 33548-4911 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2007 |
Last Update Date | 30/07/2008 |