Healthcare Provider Details

I. General information

NPI: 1881207041
Provider Name (Legal Business Name): MADISON MAUNEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2020
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8520 CLIFF CAMERON DR STE 140
CHARLOTTE NC
28269-0013
US

IV. Provider business mailing address

109 OAK HILL DR
HUNTERSVILLE NC
28078-8929
US

V. Phone/Fax

Practice location:
  • Phone: 980-202-7452
  • Fax: 866-500-2186
Mailing address:
  • Phone: 704-277-4974
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number3635
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: