Provider Demographics
NPI:1194491647
Name:MATTHEWS, NATALIE DAWN
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:DAWN
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:DAWN
Other - Last Name:MORRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2108 LAFAYETTE DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-2007
Mailing Address - Country:US
Mailing Address - Phone:405-585-7607
Mailing Address - Fax:
Practice Address - Street 1:2240 36TH AVE NW STE 100
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-3251
Practice Address - Country:US
Practice Address - Phone:405-253-0071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician