Individual
MATTHEW N AVASAKDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
1930 FREQUENT FLYER PT, COLORADO SPRINGS, CO 80915-1500
(941) 275-4422
Mailing address
4140 BROWN STONE VW, COLORADO SPRINGS, CO 80923-4492
(941) 275-4422
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-43166
—
106S00000X
Behavior Technician
RBT-18-50060
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102463800
—
FL
Enumeration date
04/05/2019
Last updated
03/15/2021
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