Individual
ISABELLE JOLIE MACKRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5526 N ACADEMY BLVD STE 109, COLORADO SPRINGS, CO 80918-3688
(719) 301-5100
Mailing address
5526 N ACADEMY BLVD STE 109, COLORADO SPRINGS, CO 80918-3688
(719) 301-5100
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-9393-428937
CO
Other
Enumeration date
08/19/2022
Last updated
08/19/2022
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