Individual
COLLEEN MATLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC CANDIDATE
Contact information
Practice address
123 W 6TH AVE, BRISTOW, OK 74010-2801
(918) 510-7412
Mailing address
123 W 6TH AVE, BRISTOW, OK 74010-2801
(918) 510-7412
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/03/2014
Last updated
06/04/2019
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