Brazeel, Madison Lauren

Brazeel, Madison Lauren is an individual health care provider with primary practice located at 2625 N 19Th St , Bismarck ND 58503-0574. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavior Technician, Speech, Language and Hearing Service Providers / Speech-Language Pathologist. Speech, Language and Hearing Service Providers / Speech-Language Pathologist is her primary health care specialty. Brazeel, Madison Lauren can be contacted via phone (701) 222-3175.

Contact Information

Primary practice address
2625 N 19Th St Bismarck ND 58503-0574
Phone: (701) 222-3175
Fax: (701) 222-3186
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X RBT-18-64141 California
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 1947 North Dakota

Profile Details

NPI number 1023590643
LBN Legal business name Brazeel, Madison Lauren
Credentials MS, CCC-SLP
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2018
Last updated Apr 19th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023590643 NPPES
North Dakota MEDICAID 1483045

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