Individual
KARITA ROCHELLE MATLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6414 E 17TH ST, KANSAS CITY, MO 64126-2528
(816) 612-1206
Mailing address
6414 E 17TH ST, KANSAS CITY, MO 64126-2528
(816) 612-1206
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
KS
172V00000X
Community Health Worker
—
MO
Other
Enumeration date
10/26/2021
Last updated
10/26/2021
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