Tiara Mattox
Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child in Bronx, NY. Individual provider (NPI-1).
NPI number1194477901
StatusActive
Last updated in NPPESJan 23, 2022
Details
- NPI
- 1194477901
- Entity type
- Individual (NPI-1)
- Name
- Tiara Mattox
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 23, 2022
- Certification date
- Jan 23, 2022
- Last updated
- Jan 23, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 385HR2060X | Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | – | – | Yes |
Practice location
120 Casals Pl Apt 13cBronx, NY 10475-3138
Phone 917-639-8277
Mailing address
120 Casals Pl Apt 13cBronx, NY 10475-3138
Phone 917-639-8277
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