Provider Demographics
NPI:1750162301
Name:WALTERS, MADISON LEIGH (RBT)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:LEIGH
Last Name:WALTERS
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44303-1411
Mailing Address - Country:US
Mailing Address - Phone:330-996-4600
Mailing Address - Fax:
Practice Address - Street 1:611 W MARKET ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44303-1411
Practice Address - Country:US
Practice Address - Phone:330-996-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-10
Last Update Date:2025-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRBT-23-301515106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician