Individual
MADISON ANGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12625 S CLINTON ST, OLATHE, KS 66061-6325
(913) 295-4631
Mailing address
12625 S CLINTON ST, OLATHE, KS 66061-6325
(913) 289-1281
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/01/2024
Last updated
07/01/2024
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