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Individual

DR. MATTHEW AARON SOUTHARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
287 W 147TH ST APT 5C, NEW YORK, NY 10039-3443
(716) 908-3059
Mailing address
287 W 147TH ST APT 5C, NEW YORK, NY 10039-3443
(716) 908-3059

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
023407
NY

Other

Enumeration date
05/26/2020
Last updated
05/26/2020
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