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Individual

ASHLEY MADDEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
900 W STATE HIGHWAY 6, WACO, TX 76712-3775
(254) 300-5090
Mailing address
903 PARKVIEW CIR, HEWITT, TX 76643-3265
(903) 312-1315

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
22238071
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
22238071
BACB
TX
Enumeration date
10/10/2022
Last updated
10/10/2022
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