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General NPI Number Information
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NPI Number | 1851913685
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Entity Type | Individual
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Provider Name | MATHEW T VERDON BCBA
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Gender | Male
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Dates
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Enumeration Date | 05/14/2020
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Last Update Date | 05/06/2022
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Provider Practice Location Address
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Address Line | 12780 WATERFORD LAKES PKWY STE 127
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City | ORLANDO
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State | FL
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Zip | 32828-4501
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Country | US
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Telephone | 407-276-2853
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Fax | 407-598-5592
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Provider Business Mailing Address
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Address Line | 12780 WATERFORD LAKES PKWY STE 127
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City | ORLANDO
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State | FL
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Zip | 32828-4501
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Country | US
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Telephone | 407-276-2853
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Fax | 407-598-5592
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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 | 1-22-59285
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License Number State | FL
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