Individual
MS. ANGELA ROSE MATOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC CANDIDATE
Contact information
Practice address
500 N MERIDIAN AVE STE 406, OKLAHOMA CITY, OK 73107-5755
(405) 818-5049
(833) 597-8370
Mailing address
20200 N HARRAH RD, LUTHER, OK 73054-9707
(405) 818-5049
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
7384
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200695330A
—
OK
Enumeration date
03/03/2017
Last updated
01/02/2020
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