Individual
MARY MATKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, LADC
Contact information
Practice address
2727 S 137TH WEST AVE, SAND SPRINGS, OK 74063-5017
(918) 245-0231
(918) 241-5031
Mailing address
PO BOX 1101, TULSA, OK 74101-1101
(918) 245-0231
(918) 241-5031
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
125
OK
101YP2500X
Professional Counselor
2027
OK
Other
Enumeration date
09/29/2011
Last updated
09/29/2011
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