Theresa Ann Mata

NPI #1124912928 in Yukon, Oklahoma

Provider Information

NPI Number: 1124912928
Entity Type: Individual
Name: Theresa Ann Mata
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Peer Specialist
Enumeration Date: Jun 5, 2025
Last Updated: Jun 5, 2025

Practice Location

Address: 1208 GARDEN GRV
City: Yukon
State: Oklahoma
ZIP Code: 73099-4956
Phone: (918) 922-4817

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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