Individual
KELLY MATLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
270 N DENTON TAP RD STE 160, COPPELL, TX 75019-2133
(972) 304-0700
Mailing address
270 N DENTON TAP RD STE 160, COPPELL, TX 75019-2133
(972) 304-0700
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
82361
TX
Other
Enumeration date
09/17/2021
Last updated
09/17/2021
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