Individual
MCKENNA DYNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1511 HERITAGE LN STE 1, FLORENCE, SC 29505-3141
(843) 536-8674
Mailing address
PO BOX 931142, ATLANTA, GA 31193-1142
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-306070
SC
Other
Enumeration date
10/31/2023
Last updated
10/31/2023
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