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Individual

MATT WORKMAN

Active
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Individual

MATT WORKMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BA0000174
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BA0000174
DIVISION OF INTELLECTUAL AND DEVELOPMENTAL DISABILITIES
TN
Enumeration date
11/16/2015
Last updated
09/10/2018
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