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1073854071
ETHAN MATSON
DURANT, OK
NPI
1073854071
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2013-03-15
Last Update Date
2013-03-15
Business Address
-- ETHAN MATSON
1602 TIMBERLINE DR
DURANT, OK 74701-2339
Phone number: 580-916-8604
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Mailing Address
-- ETHAN MATSON
1602 TIMBERLINE DR
DURANT, OK 74701-2339
Phone number: 580-916-8604
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