=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982327276
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MADELYN GRACE WILLIAMS RBT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/21/2022
-----------------------------------------------------
Last Update Date | 01/02/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1300 N PALAFOX ST STE 103
-----------------------------------------------------
City | PENSACOLA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32501-2678
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 850-860-2903
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 527 S 2ND ST
-----------------------------------------------------
City | PENSACOLA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32507-3313
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 251-284-6519
-----------------------------------------------------
Fax | 910-777-7819
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number | 1-25-86503
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------