Individual
DR. MATTHEW DOUGLAS BUSICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, BCBA, LBA
Contact information
Practice address
2233 CAHABA VALLEY DR, BIRMINGHAM, AL 35242-2602
(205) 718-9519
Mailing address
5636 6TH CT S, BIRMINGHAM, AL 35212-3734
(205) 718-9519
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2017-141
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-06-3188
BCBA CERTIFICATION #
—
01
—
12315497
CAQH PROFILE #
—
01
—
2017-141
ALABAMA LICENSED BEHAVIOR ANALYST
AL
Enumeration date
03/18/2009
Last updated
11/05/2020
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