Individual
MACKAYLA KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6836 ISAAC'S ORCHARD RD, SPRINGDALE, AR 72762
(479) 927-4100
(479) 927-4101
Mailing address
6836 ISAAC'S ORCHARD RD, SPRINGDALE, AR 72762
(479) 927-4100
(479) 927-4101
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-58618
AR
106S00000X
Behavior Technician
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
232692706
—
AR
01
—
236454795
MEDICAID PIN
—
Enumeration date
02/09/2020
Last updated
02/02/2023
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