Healthcare Provider Details

I. General information

NPI: 1407429707
Provider Name (Legal Business Name): MADYSON ELISA CHAMBERS RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2021
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2002 E ROBINSON ST
NORMAN OK
73071-7420
US

IV. Provider business mailing address

2002 E ROBINSON ST
NORMAN OK
73071-7420
US

V. Phone/Fax

Practice location:
  • Phone: 405-307-2800
  • Fax:
Mailing address:
  • Phone: 580-699-5558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-87456
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: