Individual
STAISHA MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
5328 LANIER ISLANDS PKWY UNIT 101, BUFORD, GA 30518-9071
(470) 655-1970
(470) 655-1048
Mailing address
300 INTERNATIONAL PKWY STE 200, LAKE MARY, FL 32746-5028
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-63904
GA
106S00000X
Behavior Technician
RBT-19-87865
GA
Other
Enumeration date
01/02/2020
Last updated
06/11/2025
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