Most Relevant Information
Provider Data
| NPI Number: | 1003422759 |
| Provider Name: | MATTHEW PROSCH |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/18/2020 |
| Last Updated: | 09/18/2020 |
Provider Practice Location
200 VESTAVIA PKWY STE 2400
VESTAVIA
AL
352163797
Practice Location Phone/Fax
| Phone: | 3129652997 |
| Fax: |
Provider Mailing Location
306 N KENSINGTON AVE
LA GRANGE PARK
IL
605261870
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |