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General NPI Number Information
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NPI Number | 1841157682
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Entity Type | Individual
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Provider Name | MADELYN PHELPS
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Gender | Female
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Dates
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Enumeration Date | 01/05/2026
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 1910 CHERRY PL
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City | EDGEWOOD
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State | MD
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Zip | 21040-2410
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Country | US
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Telephone | 667-331-0621
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Fax |
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Provider Business Mailing Address
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Address Line | 1910 CHERRY PL
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City | EDGEWOOD
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State | MD
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Zip | 21040-2410
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Country | US
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Telephone | 667-331-0621
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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 | MD-10275236012
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License Number State | MD
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