Healthcare Provider Details

I. General information

NPI: 1770406373
Provider Name (Legal Business Name): HEATHER MATHESS
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3532 BINBROOK RD N
COLUMBUS OH
43227-3514
US

IV. Provider business mailing address

3532 BINBROOK RD N
COLUMBUS OH
43227-3514
US

V. Phone/Fax

Practice location:
  • Phone: 380-238-2155
  • Fax:
Mailing address:
  • Phone: 380-238-2155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: