Individual
ETHAN MATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1602 TIMBERLINE DR, DURANT, OK 74701-2339
(580) 916-8604
Mailing address
1602 TIMBERLINE DR, DURANT, OK 74701-2339
(580) 916-8604
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/15/2013
Last updated
03/15/2013
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