| Doctor Name: | MARLA MATTOX |
| NPI Number: | 1003942681 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | RN9202232 |
| Business Practice Address: | 1220 Willis Ave Daytona Beach, FL - 321142810 |
| Business Phone Number: | 3862363194 |
| Business Fax Number: | 3862363178 |
| Mailing Address: | 4130 Falling Leaf Dr, NEW SMYRNA BEACH |
| State: | FL |
| Postal Code: | 321689107 |
| Phone Number: | 3862363194 |
| Fax Number: | |
| NPI Enumeration Date: | 02/26/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0809X |
| License Number: | RN9202232 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health, Adult |
| Taxonomy Definition: | |