Provider Demographics
NPI:1346002649
Name:MATOS, ANDREW NICHOLAS (RBT)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:NICHOLAS
Last Name:MATOS
Suffix:
Gender:M
Credentials:RBT
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Mailing Address - Street 1:350 FAIRWAY DR STE 101
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-1834
Mailing Address - Country:US
Mailing Address - Phone:877-418-2978
Mailing Address - Fax:619-374-7134
Practice Address - Street 1:2453 GRAND CANAL BLVD STE A
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-8138
Practice Address - Country:US
Practice Address - Phone:855-223-7123
Practice Address - Fax:619-374-7134
Is Sole Proprietor?:No
Enumeration Date:2024-01-23
Last Update Date:2024-03-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician