Individual
MAKENNA ROBINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
859 SOUTH HIGHWAY 191, SUITE #202, REXBURG, ID 83440
(307) 257-5487
Mailing address
PO BOX 20310, PMB 55984, CHEYENNE, WY 82003-7007
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/01/2022
Last updated
11/01/2022
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