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Individual

MIKAYLA CRISTA CONNEEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5411 JEFFERSON ST NE, ALBUQUERQUE, NM 87109-3473
(951) 218-3766
Mailing address
27777 INKSTER RD STE 100, FARMINGTON HILLS, MI 48334-5312
(951) 218-3766

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-70391
CA
103K00000X
Behavior Analyst
106S00000X
Behavior Technician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1679041495
CA
Enumeration date
11/29/2022
Last updated
06/06/2025
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