Individual
MRS. TARA MATLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
13929 TECHNOLOGY DR, OKLAHOMA CITY, OK 73134-1053
(405) 496-1511
Mailing address
13929 TECHNOLOGY DR STE A, OKLAHOMA CITY, OK 73134-1053
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
10454
OK
Other
Enumeration date
01/11/2022
Last updated
01/11/2022
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