MEDICARE: MATTHEW THAD PAINTER BCBA, COBA

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
1	103K00000X	Behavior Analyst	COBA.01921	OH

General Provider Information

NPI Number	:	1326712621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW THAD PAINTER BCBA, COBA

Provider Business Mailing Address
First Line	:	501 COMMONS DR
Second Line	:
City	:	MILFORD
State	:	OH
Zip	:	45150-1921
Country	:	US
Telephone Number	:	513-874-6789
Fax Number	:	317-520-8200

Provider Business Practice Location Address
First Line	:	100 COMMERCIAL DR
Second Line	:
City	:	FAIRFIELD
State	:	OH
Zip	:	45014-5556
Country	:	US
Telephone Number	:	513-874-6789
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2021
Last Update Date	:	04/10/2026

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