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General NPI Number Information
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NPI Number | 1215855457
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Entity Type | Individual
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Provider Name | PAOLA BEATRIZ VELAZQUEZ- GONZALEZ DR
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Gender | Female
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Dates
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Enumeration Date | 07/07/2026
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Last Update Date | 07/07/2026
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Provider Practice Location Address
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Address Line | 35 MICHIGAN ST NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-2514
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Country | US
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Telephone | 616-267-2500
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Fax |
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Provider Business Mailing Address
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Address Line | 113 LARKIN DR
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City | MECHANICSBURG
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State | PA
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Zip | 17055-5238
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Country | US
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Telephone | 787-241-6973
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6301019869
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License Number State | MI
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