Individual
MACKENZIE ERIN CLEGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
790 FULLER AVE NE, GRAND RAPIDS, MI 49503-1918
(616) 336-3909
(616) 336-8830
Mailing address
14166 8TH AVE, MARNE, MI 49435-9759
(248) 805-2643
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
247200000X
Other Technician
—
—
Other
Enumeration date
10/14/2016
Last updated
04/10/2025
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