Provider Information for 1649794116
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MATTHEW RYAN TAPIA MA, BCBA, LMFT, LBA
Sex: Male
NPI: 1649794116
Last Updated: 2023-12-06
Certification Date: 2023-12-06
Certification Date: 2023-12-06
Details
| Name | Value | ||||||||||||||||
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| NPI | 1649794116 | ||||||||||||||||
| Enumeration Date | 2017-07-27 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | NO | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 3500 DEPAUW BLVD STE 3070 INDIANAPOLIS, IN 46268-6135 United States Phone: 855-324-0885 | Fax:317-520-8200 | ||||||||||||||||
| Primary Practice Address | 3602 E GREENWAY RD STE 102 PHOENIX, AZ 85032-4648 United States Phone: 602-560-2832 | Fax:317-520-8200 | ||||||||||||||||
| Secondary Practice Address(es) | 4502 E PARADISE VILLAGE PKWY S APT 1032 | ||||||||||||||||
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