Individual
DR. JAYA MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1340 PRUDENTIAL DR # B, DALLAS, TX 75235-4115
(214) 275-4667
Mailing address
21 N BUTLER ST APT 504, MADISON, WI 53703-4229
(214) 755-7532
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
3065-57
WI
103T00000X
Psychologist
Primary
36584
TX
Other
Enumeration date
04/26/2007
Last updated
06/18/2014
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