Provider Demographics
NPI:1043019060
Name:DASHNER, MADISON KAYLYNN (RBT)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:KAYLYNN
Last Name:DASHNER
Suffix:
Gender:
Credentials:RBT
Other - Prefix:
Other - First Name:MADISON
Other - Middle Name:KAYLYNN
Other - Last Name:ROWE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1360 CADUCEUS WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-7300
Mailing Address - Country:US
Mailing Address - Phone:762-499-3476
Mailing Address - Fax:
Practice Address - Street 1:1360 CADUCEUS WAY STE 101
Practice Address - Street 2:
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-7300
Practice Address - Country:US
Practice Address - Phone:762-499-3476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-11
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARBT-24-349315106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician