Provider Demographics
NPI:1578319810
Name:SCOTT, MATHEW LEE (RBT, CBT)
Entity Type:Individual
Prefix:
First Name:MATHEW
Middle Name:LEE
Last Name:SCOTT
Suffix:
Gender:M
Credentials:RBT, CBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 E MAGNESIUM RD APT 247
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-7302
Mailing Address - Country:US
Mailing Address - Phone:509-828-7293
Mailing Address - Fax:
Practice Address - Street 1:8506 N WALL ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-6164
Practice Address - Country:US
Practice Address - Phone:509-328-1582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-26
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician