Individual
KEONNA MCDOUGALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MAT
Contact information
Practice address
1914 J N PEASE PL, CHARLOTTE, NC 28262-4504
(704) 919-3542
Mailing address
1919 BIRCHBROOK CT, HARRISBURG, NC 28075-6690
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
05/20/2009
Last updated
05/20/2009
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