Provider Demographics
NPI:1922692524
Name:MATSON, VALERIE LEIGH (RBT)
Entity Type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:LEIGH
Last Name:MATSON
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 1/2 SEWARD SQ SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-1113
Mailing Address - Country:US
Mailing Address - Phone:443-690-5857
Mailing Address - Fax:
Practice Address - Street 1:6169 STONEPATH CIR
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20120-3419
Practice Address - Country:US
Practice Address - Phone:614-981-3238
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-19-81425103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst