Individual
MADISON ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1717 S AIR DEPOT BLVD, MIDWEST CITY, OK 73110-5103
(405) 622-4239
Mailing address
1717 S AIR DEPOT BLVD, MIDWEST CITY, OK 73110-5103
(405) 622-4239
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/28/2022
Last updated
07/28/2022
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