Individual provider · NPI-1

Marla Mattox, RN

Registered Nurse, Psych/Mental Health, Adult · Daytona Beach, FL

NPI number1003942681

StatusActive

Last updated in NPPESJul 8, 2007

Details

NPI: 1003942681
Entity type: Individual (NPI-1)
Name: Marla Mattox
Credential: RN
Sex: Female
Sole proprietor: Yes
Enumeration date: Feb 26, 2007
Last updated: Jul 8, 2007

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
163WP0809X	Registered Nurse, Psych/Mental Health, Adult	RN9202232	FL	Yes

Practice location

1220 Willis Ave
Daytona Beach, FL 32114-2810

Phone 386-236-3194 · Fax 386-236-3178

Mailing address

4130 Falling Leaf Dr
New Smyrna Beach, FL 32168-9107

Phone 386-236-3194

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