Individual
NICOLE MCKENZIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9115 S CICERO AVE STE 200, OAK LAWN, IL 60453-1771
(773) 449-0859
Mailing address
14840 SHEPARD DR, DOLTON, IL 60419-2467
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
11/02/2021
Last updated
11/26/2021
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