Individual
MADISON SEWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1212 S AIR DEPOT BLVD STE 9, MIDWEST CITY, OK 73110-4860
(405) 455-6868
(405) 562-3444
Mailing address
PO BOX 33568, SAN DIEGO, CA 92163-3568
(855) 223-7123
(619) 374-7134
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-280508
OK
106S00000X
Behavior Technician
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Other
Enumeration date
06/05/2023
Last updated
05/23/2024
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