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General NPI Number Information
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NPI Number | 1144833773
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Entity Type | Individual
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Provider Name | MADELINE WELLS MA, BCBA
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Gender | Female
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Dates
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Enumeration Date | 08/24/2020
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 416 W 15TH ST STE 600
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City | EDMOND
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State | OK
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Zip | 73013-3672
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Country | US
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Telephone | 405-389-4530
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Fax |
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Provider Business Mailing Address
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Address Line | 14521 TRAVERTINE FALLS LN
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City | OKLAHOMA CITY
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State | OK
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Zip | 73142-8519
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Country | US
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Telephone | 817-891-2218
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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