Healthcare Provider Details

I. General information

NPI: 1134032683
Provider Name (Legal Business Name): RYAN MATTHEW BIEMULLER BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 DEERFIELD LN STE 100
MALVERN PA
19355-2100
US

IV. Provider business mailing address

2435 WYNNEFIELD DR
HAVERTOWN PA
19083-1654
US

V. Phone/Fax

Practice location:
  • Phone: 484-631-3492
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberLBA1749
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: