Individual
MADYSON MICHELE WICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
11432 TESSON FERRY RD, SAINT LOUIS, MO 63123-6925
(217) 525-8332
(217) 789-1420
Mailing address
5220 6TH STREET FRONTAGE RD E STE 1700, SPRINGFIELD, IL 62703-5771
(217) 525-8332
(217) 789-1420
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-25-81340
MO
106S00000X
Behavior Technician
—
—
Other
Enumeration date
07/24/2023
Last updated
09/16/2025
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