Individual
MATTHEW JAMES BLAZEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
42 BAR HARBOR TER, CHARLES TOWN, WV 25414-1216
(415) 990-3608
Mailing address
42 BAR HARBOR TER, CHARLES TOWN, WV 25414-1216
(415) 990-3608
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
11/18/2015
Last updated
08/17/2021
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