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General NPI Number Information
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NPI Number | 1194304584
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Entity Type | Individual
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Provider Name | MADISON BONSALL BCBA
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Gender | Female
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Dates
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Enumeration Date | 04/05/2021
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Last Update Date | 12/29/2024
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Provider Practice Location Address
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Address Line | 1101 ARROW POINT DR STE 305
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City | CEDAR PARK
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State | TX
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Zip | 78613-7740
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Country | US
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Telephone | 512-605-0069
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Fax | 512-532-6160
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Provider Business Mailing Address
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Address Line | 1101 ARROW POINT DR STE 305
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City | CEDAR PARK
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State | TX
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Zip | 78613-7740
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Country | US
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Telephone | 512-605-0069
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Fax | 512-532-6160
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-23-70349
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License Number State | TX
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