Provider Demographics
NPI:1912134867
Name:LAW, MATTHEW (BCBA)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:LAW
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 1:202 BRITISH WOODS DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-3336
Mailing Address - Country:US
Mailing Address - Phone:256-898-5360
Mailing Address - Fax:
Practice Address - Street 1:202 BRITISH WOODS DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217-3336
Practice Address - Country:US
Practice Address - Phone:256-898-5360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-18
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1-08-4631103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst