| Provider / Organization | NPI | Date Certified |
|---|---|---|
| MADISON ALEXANDRIA TOLLEY | 1073228029 | 2023-01-13 |
Madison Alexandria Tolley is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1073228029. Registration indicates Madison Alexandria Tolley is a provider of services with a specialization in Behavioral Health & Social Service Providers, Behavior Technician (Behavior Technician, Behavioral Health & Social Service Providers) (Behavior Technician, )
| Entity Type | Individual |
| Provider Name | Madison Alexandria Tolley |
| Practice Office Address | 905 FRIEDBERG CHURCH RD WINSTON SALEM, NC US |
| Practice Office Telephone | 3362511180 |
| Mailing Address | 5973 KENVILLE GREEN CIR KERNERSVILLE, NC 272847128 US |
| Business Telephone | 3362511180 |
| Code | Practice | License No State |
|---|---|---|
| 106S00000X PRIMARY | Behavioral Health & Social Service Providers Behavior Technician Behavior Technician Behavioral Health & Social Service Providers Behavior Technician |