Individual
LEAH B MATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6294 SE 130TH ST, BELLEVIEW, FL 34420-5927
(352) 598-9323
Mailing address
6294 SE 130TH ST, BELLEVIEW, FL 34420-5927
(352) 598-9323
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
07/15/2025
Last updated
07/15/2025
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