Individual
CAROLINE MATLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1902 MEAD AVE, SHEBOYGAN, WI 53081-6140
(920) 458-8333
Mailing address
2225 SAMANTHA ST APT 43, DE PERE, WI 54115-8047
(920) 450-4192
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5205
WI
Other
Enumeration date
12/29/2015
Last updated
12/29/2015
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