Individual
MICHELLE MATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
565 LAKEVIEW PKWY STE 150, VERNON HILLS, IL 60061-1839
(877) 486-4140
Mailing address
1454 CARRIAGE LN, LAKE VILLA, IL 60046-7003
(224) 308-2415
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
05/28/2026
Last updated
05/28/2026
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