IBTISAM MATTA

GRAND RAPIDS, MI
NPI1063176543
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent
(Licence: MI  4704359386)
Enumeration Date2021-10-29
Last Update Date2021-10-29
Business Address
IBTISAM MATTA RN
790 FULLER AVE NE
GRAND RAPIDS, MI 49503-1918
Phone number: 616-336-3765
Mailing Address
IBTISAM MATTA RN
2610 RILEY AVE SW
WYOMING, MI 49509-2016
Phone number: 517-331-3895