Individual
ANNIE MAE MATHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
525 S WILSON ST, VINITA, OK 74301-4646
(580) 786-0767
Mailing address
41247 HIGHWAY 29, WYNNEWOOD, OK 73098-9116
(580) 670-3117
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/17/2022
Last updated
10/17/2022
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