DIANA D MATLACK

SPRING, TX
NPI1922097187
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy367A00000X Advanced Practice Midwife
(Licence: NY  F000623)
Additional Taxonomies367A00000X Advanced Practice Midwife
(Licence: TX  245276)
Enumeration Date2005-10-19
Last Update Date2013-03-14
Business Address
-- DIANA D MATLACK CNM
2495 SAWDUST RD APT 1101
SPRING, TX 77380-3365
Phone number: 315-216-6625
Mailing Address
-- DIANA D MATLACK CNM
2495 SAWDUST RD APT 1101
SPRING, TX 77380-3365
Phone number: