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General NPI Number Information
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NPI Number | 1952873119
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Entity Type | Individual
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Provider Name | MADISON BAIN NEWMAN BCBA
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Gender | Female
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Dates
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Enumeration Date | 12/27/2018
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Last Update Date | 12/31/2024
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Provider Practice Location Address
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Address Line | 307 N MAIN ST
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City | RUSHVILLE
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State | IN
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Zip | 46173-1635
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Country | US
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Telephone | 463-222-7945
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Fax |
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Provider Business Mailing Address
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Address Line | 6540 W 400 N
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City | ARLINGTON
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State | IN
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Zip | 46104-9418
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Country | US
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Telephone | 317-441-0249
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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 | 1-18-33103
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License Number State |
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