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NPI Code Detail

MEDICARE: MR. STEVEN MATTHEW MATTA MS

MEDICARE: MR. STEVEN MATTHEW MATTA MS
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 Analyst

General Provider Information

NPI Number : 1275964256
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. STEVEN MATTHEW MATTA MS
Provider Business Mailing Address
First Line : PO BOX 749
Second Line :
City : BELMONT
State : NC
Zip : 28012-0749
Country : US
Telephone Number : 704-869-2088
Fax Number :
Provider Business Practice Location Address
First Line : 54 MYRTLE ST
Second Line :
City : BELMONT
State : NC
Zip : 28012-5200
Country : US
Telephone Number : 704-954-8959
Fax Number : 980-207-2773
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2013
Last Update Date : 06/11/2024

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