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NPI Code Detail

MEDICARE: EMILY MATA

MEDICARE: EMILY MATA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-18-31745MD

General Provider Information

NPI Number : 1528594363
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY MATA
Provider Business Mailing Address
First Line : 7120 SAMUEL MORSE DR STE 150
Second Line :
City : COLUMBIA
State : MD
Zip : 21046-3420
Country : US
Telephone Number : 888-344-5977
Fax Number :
Provider Business Practice Location Address
First Line : 5310 SPECTRUM DR
Second Line :
City : FREDERICK
State : MD
Zip : 21703-7362
Country : US
Telephone Number : 888-726-4774
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2017
Last Update Date : 01/13/2026

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Directions to “ EMILY MATA ” Practice Location

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