ETHAN MATSON

DURANT, OK
NPI1073854071
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2013-03-15
Last Update Date2013-03-15
Business Address
-- ETHAN MATSON
1602 TIMBERLINE DR
DURANT, OK 74701-2339
Phone number: 580-916-8604
Mailing Address
-- ETHAN MATSON
1602 TIMBERLINE DR
DURANT, OK 74701-2339
Phone number: 580-916-8604
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