Provider Demographics
NPI:1003097312
Name:MATHUR, AARTI (PSYD)
Entity type:Individual
Prefix:
First Name:AARTI
Middle Name:
Last Name:MATHUR
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16444 TURNBURY OAK DR
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:FL
Mailing Address - Zip Code:33556-2887
Mailing Address - Country:US
Mailing Address - Phone:813-313-9415
Mailing Address - Fax:813-333-6967
Practice Address - Street 1:18958 DALE MABRY HWY N
Practice Address - Street 2:SUITE 102
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33548-4911
Practice Address - Country:US
Practice Address - Phone:813-313-9415
Practice Address - Fax:813-333-6967
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-15
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7589103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical