Provider Demographics
NPI:1730826926
Name:MATZ GELSKY, BETTY
Entity type:Individual
Prefix:
First Name:BETTY
Middle Name:
Last Name:MATZ GELSKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7528 BROMWICH CT
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-6450
Mailing Address - Country:US
Mailing Address - Phone:786-728-6381
Mailing Address - Fax:
Practice Address - Street 1:7528 BROMWICH CT
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75252-6450
Practice Address - Country:US
Practice Address - Phone:786-728-6381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH0004197101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty