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NPI Code Detail

MEDICARE: MADISON POLLOCK BCBA

MEDICARE: MADISON POLLOCK BCBA
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
1103K00000XBehavior Analyst1-24-70843OK

General Provider Information

NPI Number : 1912760539
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADISON POLLOCK BCBA
Provider Business Mailing Address
First Line : 3500 DEPAUW BLVD STE 3070
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46268-6135
Country : US
Telephone Number : 855-324-0885
Fax Number : 317-520-8200
Provider Business Practice Location Address
First Line : 16538 N MAY AVE
Second Line :
City : EDMOND
State : OK
Zip : 73012-9007
Country : US
Telephone Number : 405-265-9208
Fax Number : 317-520-8200
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2024
Last Update Date : 03/03/2026

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Directions to “ MADISON POLLOCK BCBA” Practice Location

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