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Organization
DAVIKA MATTOX PMHNP RECOVERY AND WELLNESS BEHAVIORAL HEALTH
Active
Organization
DAVIKA MATTOX PMHNP RECOVERY AND WELLNESS BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVIKA MATTOX (OWNER)
(859) 432-2168
Entity
Organization
Contact information
Practice address
3208 POLO CLUB BLVD, LEXINGTON, KY 40509-8454
(859) 432-2168
Mailing address
3208 POLO CLUB BLVD, LEXINGTON, KY 40509-8454
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/05/2018
Last updated
06/05/2018
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