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General NPI Number Information
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NPI Number | 1609608702
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Entity Type | Individual
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Provider Name | PEDRO ENRIQUE POOT MATU BCBA
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Gender | Male
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Dates
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Enumeration Date | 08/16/2024
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Last Update Date | 12/22/2025
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Provider Practice Location Address
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Address Line | 301 EDGEWATER PL STE 100
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City | WAKEFIELD
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State | MA
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Zip | 01880-1281
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Country | US
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Telephone | 855-832-6727
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Fax |
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Provider Business Mailing Address
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Address Line | 8910 SW 150TH COURT CIR N
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City | MIAMI
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State | FL
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Zip | 33196-1332
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Country | US
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Telephone | 784-746-6104
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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 | 1-20-45189
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License Number State |
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