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General NPI Number Information
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NPI Number | 1053788349
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Entity Type | Individual
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Provider Name | ANNIKA MATOS
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Gender | Female
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Dates
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Enumeration Date | 08/21/2015
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Last Update Date | 08/21/2015
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Provider Practice Location Address
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Address Line | 5867 WHITAKER RD
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City | NAPLES
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State | FL
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Zip | 34112-2963
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Country | US
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Telephone | 239-774-2904
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Fax |
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Provider Business Mailing Address
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Address Line | 26686 LITTLE JOHN CT APT 75
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-7313
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Country | US
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Telephone | 239-297-3885
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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