NPI 1003280777 · live from the CMS NPI Registry
Matthew James Blazek, BCBA
Behavior Analyst in Charles Town, WV. National Provider Identifier 1003280777, active.
NPI record
| NPI | 1003280777 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 42 Bar Harbor Ter, Charles Town, WV 25414 |
| Practice phone | 415-990-3608 |
| Enumerated | November 18, 2015 |
| Last updated | August 17, 2021 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst primary | 103K00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.