Individual
MATTHEW B GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1660 PICCARD DR, ROCKVILLE, MD 20850-6693
(313) 410-9626
Mailing address
1660 PICCARD DR, ROCKVILLE, MD 20850-6693
(313) 410-9626
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301007510
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
680H224080
BCBSM
MI
Enumeration date
05/25/2006
Last updated
06/10/2009
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