Individual
MADELINE NICOLE COBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2740 COLLEGE AVE, CONWAY, AR 72034-6141
(501) 329-5459
Mailing address
2740 COLLEGE AVE, CONWAY, AR 72034-6141
(501) 329-5459
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-72178
AR
106S00000X
Behavior Technician
—
AR
Other
Enumeration date
11/12/2019
Last updated
04/03/2024
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