Individual
REBECA EVORA MATOZINHO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., BCBS, DTLLP
Contact information
Practice address
4211 PARKWAY PLACE DR SW, GRANDVILLE, MI 49418-2695
(616) 222-3700
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-22-62853
FL
103T00000X
Psychologist
Primary
—
MI
Other
Enumeration date
07/25/2017
Last updated
07/03/2024
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