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Individual

MATTIE LOUISE LOCKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
379 FM 2972 W, RUSK, TX 75785-3666
(903) 683-5781
Mailing address
379 FM 2972 W, RUSK, TX 75785-3666
(903) 683-5781

Taxonomy

Speciality
Code
Description
License number
State
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
106908
TX
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
218376
TX

Other

Enumeration date
09/17/2015
Last updated
09/17/2015
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