Provider Demographics
NPI:1750783692
Name:WILLIAMS, MATTHEW L (BCBA)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:L
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1133 HUFF RD NW
Mailing Address - Street 2:540
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-7708
Mailing Address - Country:US
Mailing Address - Phone:615-504-8439
Mailing Address - Fax:
Practice Address - Street 1:500 FAIRWAY DR
Practice Address - Street 2:#102
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-1814
Practice Address - Country:US
Practice Address - Phone:954-603-7885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-23
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst