Madison Nash

Individual provider Active NPI Behavior Technician · Bloomingdale, GA

NPI 1073329645 · NPPES record last updated Dec 9, 2024

Key facts

NPI
1073329645
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
180 John Carter Rd
Bloomingdale, GA 31302-8053
Phone
(904) 548-7425
NPI assigned
Dec 9, 2024
Sex
Female
Sole proprietor
Yes

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)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

180 John Carter Rd
Bloomingdale, GA 31302-8053

Mailing address

180 John Carter Rd
Bloomingdale, GA 31302-8053

Other providers in Bloomingdale, GA

All providers in Bloomingdale, GA · Behavior Technician in Georgia

Sources for this page

Verify at the official NPI Registry.