Provider Demographics
NPI:1164062881
Name:MATLOCK, CHERYL (RBT)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:MATLOCK
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 SAN FELIPE ST STE 900
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-1798
Mailing Address - Country:US
Mailing Address - Phone:866-810-0580
Mailing Address - Fax:866-611-1558
Practice Address - Street 1:32502 TAMINA RD STE 100
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77354-7451
Practice Address - Country:US
Practice Address - Phone:936-206-5158
Practice Address - Fax:346-229-1675
Is Sole Proprietor?:No
Enumeration Date:2020-01-10
Last Update Date:2025-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-17-29324106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician