MEDICARE: MADISON WARNER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	1-19-35004	TX

General Provider Information

NPI Number	:	1306429014
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADISON WARNER

Provider Business Mailing Address
First Line	:	3601 MAPLESHADE LN
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75075-5753
Country	:	US
Telephone Number	:	469-241-9100
Fax Number	:

Provider Business Practice Location Address
First Line	:	9616 GEORGE BUSH DR
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75072-5805
Country	:	US
Telephone Number	:	469-241-9100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/30/2021
Last Update Date	:	04/30/2021

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Directions to “ MADISON WARNER ” Practice Location

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