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Individual
MS. OCTAVIA DIANNE MADISON
Active
Individual
MS. OCTAVIA DIANNE MADISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.D, LPC, LMFT
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
Primary
0701001856
VA
106H00000X
Marriage & Family Therapist
0717000584
VA
Other
Enumeration date
03/20/2014
Last updated
03/20/2014
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