Individual
MADISON PROCTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 3 MILE RD NW STE 200, GRAND RAPIDS, MI 49544-1691
(586) 995-6658
Mailing address
600 3 MILE RD NW STE 200, GRAND RAPIDS, MI 49544-1691
(586) 995-6658
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
MI
103K00000X
Behavior Analyst
Primary
—
MI
106S00000X
Behavior Technician
—
—
Other
Enumeration date
08/15/2019
Last updated
09/25/2025
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