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General NPI Number Information
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NPI Number | 1598591455
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Entity Type | Individual
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Provider Name | NIA MADISE BCBA
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Gender | Female
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Dates
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Enumeration Date | 09/09/2024
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 2045 SPRING STUEBNER RD STE 600
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City | SPRING
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State | TX
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Zip | 77389-4812
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Country | US
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Telephone | 817-562-0909
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Fax |
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Provider Business Mailing Address
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Address Line | 4920 MAGNOLIA COVE DR APT 3307
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City | KINGWOOD
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State | TX
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Zip | 77345-2249
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Country | US
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Telephone | 985-255-2119
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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 | 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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