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NPI Code Detail

MEDICARE: AMBER MADDEN

MEDICARE: AMBER MADDEN
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1366140030
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMBER MADDEN
Provider Business Mailing Address
First Line : 5704 EUPER LN
Second Line :
City : FORT SMITH
State : AR
Zip : 72903-3238
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5704 EUPER LN
Second Line :
City : FORT SMITH
State : AR
Zip : 72903-3238
Country : US
Telephone Number : 479-242-4480
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2023
Last Update Date : 04/11/2023

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Directions to “ AMBER MADDEN ” Practice Location

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