MEDICARE: MADISON UHLHORN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	1-24-70674	CA
2	106S00000X	Behavior Technician
3	103K00000X	Behavior Analyst	1480	TN

General Provider Information

NPI Number	:	1366902678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADISON UHLHORN

Provider Business Mailing Address
First Line	:	7500 SAN FELIPE ST STE 990
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77063-1708
Country	:	US
Telephone Number	:	281-826-3382
Fax Number	:	425-491-7683

Provider Business Practice Location Address
First Line	:	101 TENNESSEE WAY STE 400
Second Line	:
City	:	HENDERSONVILLE
State	:	TN
Zip	:	37075-3160
Country	:	US
Telephone Number	:	629-255-0339
Fax Number	:	615-827-0363

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2019
Last Update Date	:	08/12/2024

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Directions to “ MADISON UHLHORN ” Practice Location

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