Organization
MATTHEW B. GONZALEZ, PSY.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW B GONZALEZ PSY.D. (OWNER)
(313) 410-9626
Entity
Organization
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
MG224080
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
680H224080
BLUE CROSS
MI
Enumeration date
04/28/2008
Last updated
06/10/2009
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