Individual
MADISON D VAN ZILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 W WOODLAWN AVE, LOUISVILLE, KY 40215-2472
(502) 409-7181
(888) 450-0935
Mailing address
800 W WOODLAWN AVE, LOUISVILLE, KY 40215-2472
(502) 409-7181
(888) 450-0935
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-72008
KY
Other
Enumeration date
11/19/2019
Last updated
11/19/2019
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