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Individual

JERALD DONALD MATTERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BCBA

Contact information

Practice address
8565 FAIRFAX ST, MANASSAS, VA 20110-4815
(703) 853-3599
Mailing address
8565 FAIRFAX ST, MANASSAS, VA 20110-4815
(703) 853-3599

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary

Other

Enumeration date
02/24/2015
Last updated
02/24/2015
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