Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist | OK |
NPI | 1154648558 |
---|---|
Provider Name | Cheri L Mathews |
First Address | Poteau, OK 74953-8678 |
Second Address | Poteau, OK 74953-8678 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2010 |
Last Update Date | 23/04/2010 |