NPI | 1760638043 |
---|---|
Professional Name | ANGELLO MADISON |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 251S00000X (Licence: VA 07010007132) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2008-08-18 |
Last Update Date | 2021-07-09 |