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General NPI Number Information
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NPI Number | 1386192409
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Entity Type | Individual
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Provider Name | REBECCA GOMEZ DE TUINSTRA LP
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Gender | Female
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Dates
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Enumeration Date | 09/18/2016
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 265 KOLLEN PARK DR
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City | HOLLAND
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State | MI
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Zip | 49423-3401
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Country | US
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Telephone | 616-681-3955
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Fax |
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Provider Business Mailing Address
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Address Line | 265 KOLLEN PARK DR
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City | HOLLAND
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State | MI
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Zip | 49423-3401
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Country | US
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Telephone | 616-681-3955
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6361007294
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6301016879
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6301019583
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License Number State | MI
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