Provider Demographics
NPI:1073330817
Name:SCHURMAN, MADISON K (RBT)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:K
Last Name:SCHURMAN
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 1:900 30TH AVE S APT 528
Mailing Address - Street 2:
Mailing Address - City:MOORHEAD
Mailing Address - State:MN
Mailing Address - Zip Code:56560-2987
Mailing Address - Country:US
Mailing Address - Phone:701-936-5956
Mailing Address - Fax:
Practice Address - Street 1:4215 31ST AVE S STE A
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-7743
Practice Address - Country:US
Practice Address - Phone:701-478-0221
Practice Address - Fax:701-478-0222
Is Sole Proprietor?:No
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician