Most Relevant Information
Provider Data
| NPI Number: | 1003439027 |
| Provider Name: | MATTHEW AARON SOUTHARD PH.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 103TC0700X |
| Specialty: | Psychologist |
| License Number: | 023407 |
Most Important Dates
| Enumeration Date: | 05/26/2020 |
| Last Updated: | 05/26/2020 |
Provider Practice Location
287 W 147TH ST APT 5C
NEW YORK
NY
100393443
Practice Location Phone/Fax
| Phone: | 7169083059 |
| Fax: |
Provider Mailing Location
287 W 147TH ST APT 5C
NEW YORK
NY
100393443
Provider Mailing Phone/Fax
| Phone: | 7169083059 |
| Fax: |