Female

Staisha Matthews BCBA

Behavioral Analyst in Watkinsville, GA(View on Map)

Full Name

Staisha Matthews BCBA

NPI Number

1164061511

NPI Type

Individual Provider

Gender

Female

Enumeration Date

01/02/2020

Specialties

(Taxonomies)

Code

103K00000X
106S00000X

Primary Taxonomy

Yes
No

Licenses

State

Georgia
Georgia

License Number

1-23-63904
RBT-19-87865

Contact
Information

Purpose

Mailing
Location

Address

300 INTERNATIONAL PKWY STE 200
1360 CADUCEUS WAY STE 101

City

Lake Mary
Watkinsville

State

FL
GA

Postal Code

32746-5028
30677-7300

Country

US
US

Telephone Number

N/A
(407) 915-7258

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 02/05/2023

Provider Address

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