Individual
MARLA MATTOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1220 WILLIS AVE, DAYTONA BEACH, FL 32114-2810
(386) 236-3194
(386) 236-3178
Mailing address
4130 FALLING LEAF DR, NEW SMYRNA BEACH, FL 32168-9107
(386) 236-3194
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
RN9202232
FL
Other
Enumeration date
02/26/2007
Last updated
07/08/2007
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