Provider Demographics
NPI:1508514431
Name:EMPOWERED BEHAVIORAL ANALYSIS
Entity Type:Organization
Organization Name:EMPOWERED BEHAVIORAL ANALYSIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:570-351-3193
Mailing Address - Street 1:6107 MEMORIAL HWY STE E3
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-4576
Mailing Address - Country:US
Mailing Address - Phone:570-351-3193
Mailing Address - Fax:813-200-1253
Practice Address - Street 1:6107 MEMORIAL HWY STE E3
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-4576
Practice Address - Country:US
Practice Address - Phone:570-351-3193
Practice Address - Fax:813-200-1253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-10
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty