Individual
KEAUNTAE D MATLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1209 W HEFNER RD APT 155, OKLAHOMA CITY, OK 73114-7086
(405) 535-0050
Mailing address
1209 W HEFNER RD APT 155, OKLAHOMA CITY, OK 73114-7086
(405) 535-0050
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/13/2025
Last updated
02/13/2025
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