Individual
MATO TOPA AUGUSTINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.C.B.A
Contact information
Practice address
3361 36TH ST SE, KENTWOOD, MI 49512-2809
(616) 942-2522
Mailing address
3361 36TH ST SE, KENTWOOD, MI 49512-2809
(616) 942-2522
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-10-7442
MA
Other
Enumeration date
05/14/2013
Last updated
05/14/2013
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