Provider Demographics
NPI:1235811282
Name:SMIITH, MADISON LEIGHANN (RBT)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:LEIGHANN
Last Name:SMIITH
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2117 METRO CIR SW STE A
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5343
Mailing Address - Country:US
Mailing Address - Phone:256-701-3134
Mailing Address - Fax:
Practice Address - Street 1:2117 METRO CIR SW STE A
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5343
Practice Address - Country:US
Practice Address - Phone:256-701-3134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-01
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician