Provider Demographics
NPI:1639702863
Name:MADARA, LINDSAY PAIGE (BS ED, RBT)
Entity Type:Individual
Prefix:MISS
First Name:LINDSAY
Middle Name:PAIGE
Last Name:MADARA
Suffix:
Gender:F
Credentials:BS ED, RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 RATHTON RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3717
Mailing Address - Country:US
Mailing Address - Phone:717-885-5906
Mailing Address - Fax:
Practice Address - Street 1:1 RATHTON RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-3717
Practice Address - Country:US
Practice Address - Phone:717-885-5906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-17
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARBT-19-101421106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician