Individual
MAKENZIE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2612 LONG PRAIRIE RD STE B, FLOWER MOUND, TX 75022-4981
(855) 782-7822
Mailing address
13861 RACEWAY DR APT 533, NORTHLAKE, TX 76262-6555
(918) 978-3198
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
21-185480
TX
Other
Enumeration date
05/17/2022
Last updated
05/17/2022
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