Individual
RICHARD ALAN MATHENY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
108149 S 4803 RD, MULDROW, OK 74948-7681
(918) 875-2920
Mailing address
108149 S 4803 RD, MULDROW, OK 74948-7681
(918) 875-2920
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301004006
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
68OF34973
BLUE CROSS AND BLUE SHIELD (TRADITIONAL)
MI
Enumeration date
01/10/2007
Last updated
02/09/2015
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