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General NPI Number Information
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NPI Number | 1437810355
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Entity Type | Individual
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Provider Name | AMANDA ELIZABETH MATYAS BCBA
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Gender | Female
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Dates
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Enumeration Date | 01/03/2022
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Last Update Date | 01/03/2022
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Provider Practice Location Address
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Address Line | 56 BRUNSWICK WOODS DR
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-5601
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Country | US
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Telephone | 732-390-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 28 N MCCLELLAN AVE
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City | MANASQUAN
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State | NJ
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Zip | 08736-3100
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Country | US
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Telephone | 908-403-6803
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-21-55383
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License Number State |
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