Provider Demographics
NPI:1366123515
Name:CABLE, MADELINE (MT-BC)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:
Last Name:CABLE
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:DIXON
Mailing Address - State:IL
Mailing Address - Zip Code:61021-2821
Mailing Address - Country:US
Mailing Address - Phone:563-590-4160
Mailing Address - Fax:
Practice Address - Street 1:319 E 5TH ST
Practice Address - Street 2:SUITE 202
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50703
Practice Address - Country:US
Practice Address - Phone:563-590-4160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-31
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist