Mr. Matthew Courtney Polovick-Moulds Jr.
Mr. Matthew Courtney Polovick-Moulds Jr. is a Behavior Technician in Grand Rapids, Michigan. Registered with an NPI since 2021.
- In the registry since
- 2021
- Specialties on file
- 2
Practice location Address checks out
2814 Woodcliff Cir SEGrand Rapids, MI 49506-3155
Phone: (855) 832-6727
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Behavior Technician (primary) | Taxonomy 106S00000X |
|---|---|
| Other Technician | Taxonomy 247200000X |
Record details
| NPI number | 1043886690 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | June 2, 2021 |
| Last updated in NPPES | June 4, 2021 |
| Certification date | June 4, 2021 |
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