Individual
MYKAYLA NICOLE MATLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1960 HARPER ST, CHOCTAW, OK 73020-8095
(405) 281-1040
(405) 585-2983
Mailing address
3903 N HARRISON ST, SHAWNEE, OK 74804-1426
(405) 585-2971
(405) 585-2983
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
OK
Other
Enumeration date
01/02/2024
Last updated
05/30/2024
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