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NPI Code Detail

MEDICARE: MADELINE ELLISON

MEDICARE: MADELINE ELLISON
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
1103K00000XBehavior Analyst
2106S00000XBehavior TechnicianRBT-23-288794SD

General Provider Information

NPI Number : 1932983897
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADELINE ELLISON
Provider Business Mailing Address
First Line : 7220 W 41ST ST
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57106-6028
Country : US
Telephone Number : 605-444-9700
Fax Number :
Provider Business Practice Location Address
First Line : 7220 W 41ST ST
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57106-6028
Country : US
Telephone Number : 605-444-9700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2023
Last Update Date : 05/21/2026

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Directions to “ MADELINE ELLISON ” Practice Location

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