Provider Demographics
NPI:1346529369
Name:NEWQUIST, MATTHEW H (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:H
Last Name:NEWQUIST
Suffix:
Gender:M
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 78TH AVE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55445-2744
Mailing Address - Country:US
Mailing Address - Phone:763-416-9173
Mailing Address - Fax:
Practice Address - Street 1:7000 78TH AVE N
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55445-2744
Practice Address - Country:US
Practice Address - Phone:763-416-9173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-08
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst