Provider Demographics
NPI:1821405705
Name:FURZLAND, MATTHEW GREGORY (BCBA)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:GREGORY
Last Name:FURZLAND
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10697 W CENTENNIAL PKWY APT 3035
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89166-1516
Mailing Address - Country:US
Mailing Address - Phone:702-982-6163
Mailing Address - Fax:
Practice Address - Street 1:10697 W CENTENNIAL PKWY APT 3035
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89166-1516
Practice Address - Country:US
Practice Address - Phone:702-982-6163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-12
Last Update Date:2014-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst