Individual
DAVID MARK MADISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MALLP
Contact information
Practice address
19445 W WARREN AVE, DETROIT, MI 48228-3361
(313) 307-0088
(313) 281-2235
Mailing address
19445 W WARREN AVE, DETROIT, MI 48228-3361
(313) 307-0088
(313) 281-2235
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6361006967
MI
Other
Enumeration date
11/27/2017
Last updated
05/21/2022
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