Provider Demographics
NPI:1922547348
Name:HINSON, MADISON BLAIR
Entity Type:Individual
Prefix:MRS
First Name:MADISON
Middle Name:BLAIR
Last Name:HINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 ELWOOD DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-5212
Mailing Address - Country:US
Mailing Address - Phone:405-313-3403
Mailing Address - Fax:
Practice Address - Street 1:213 ELWOOD DR
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-5212
Practice Address - Country:US
Practice Address - Phone:405-313-3403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-17
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor