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Individual

MISS MADISON LYNN NICELY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RBT

Contact information

Practice address
1820 1ST DR, CHARLESTON, SC 29407-5756
(865) 253-5518
(888) 808-4249
Mailing address
PO BOX 80901, CHARLESTON, SC 29416-0901
(865) 253-5518
(888) 808-4249

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
12/15/2022
Last updated
12/15/2022
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