Individual
DR. LARA MAE MATTOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
3015 EAST SKELLY DRIVE, SUITE 305, TULSA, OK 74105-6317
(918) 392-4866
(918) 392-4867
Mailing address
3015 EAST SKELLY DRIVE, SUITE 305, TULSA, OK 74105-6317
(918) 392-4866
(918) 392-4867
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
06-09P
AR
103TC0700X
Clinical Psychologist
Primary
1022
OK
Other
Enumeration date
08/17/2006
Last updated
11/03/2011
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