person
Ibtisam Matta, RN
Child & Adolescent Psychiatric/Mental Health Registered Nurse in Grand Rapids, Michigan
NPI 1063176543

Ibtisam Matta is a Child & Adolescent Psychiatric/Mental Health Registered Nurse based in Wyoming, MI and is specialized in Psychiatric/Mental Health, Child & Adolescent. Ibtisam Matta practices in Grand Rapids, MI and has the professional credentials of RN. The NPI Number for Ibtisam Matta is 1063176543 and holds a License No. 4704359386 (Michigan).

The current practice location address for Ibtisam Matta is 790 Fuller Ave Ne, Grand Rapids, MI and can be reached out via phone at 616-336-3765.

Location: 790 Fuller Ave Ne, Grand Rapids, MI, 49509-2016
person
Provider Profile Details
NPI Number
1063176543
Provider Name
Ibtisam Matta
Credential
RN
Provider Entity Type
Individual
Gender
Female
Address
790 Fuller Ave Ne, Grand Rapids, MI, 49509-2016
Phone Number
616-336-3765
Fax Number
Provider Enumeration Date
10/29/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
790 Fuller Ave Ne
City
State
Zip
49503-1918
Phone Number
616-336-3765
Fax Number
person
Provider Business Mailing Address Details
Address
790 Fuller Ave Ne
City
State
Zip
49503-1918
Phone Number
616-336-3765
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Registered Nurse
Speciality
Psychiatric/Mental Health, Child & Adolescent
Taxonomy
License No.
4704359386 (Michigan)
Definition
Definition to come...
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