Matrisha Boddie
Individual provider Active NPI Behavior Technician · Winder, GA
NPI 1124897384 · NPPES record last updated Dec 28, 2023
Key facts
- NPI
- 1124897384
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 407 Tori Dr Ste 2
Winder, GA 30680-5209 - Phone
- (770) 800-0891
- NPI assigned
- Dec 28, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
407 Tori Dr Ste 2
Winder, GA 30680-5209
Mailing address
407 Tori Dr Ste 2
Winder, GA 30680-5209
Phone (770) 800-0891
Other providers in Winder, GA
- Sheri Ann Bing
- Melissa Bishop
- Jenea Blackman
- Lee Lindsey Bleshoy
- Blue Blossom Care ABA Therapy LLLP
- Rebecca Booth
- Jennifer Rose Boswell
- Jimmy Dean Broderick
- Cheyla Brookens
- Jamila Brooks
All providers in Winder, GA · Behavior Technician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 28, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.