Individual
MCKENNA CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., LBA, BCBA
Contact information
Practice address
1827 NE 44TH AVE STE 390, PORTLAND, OR 97213-1461
(503) 963-6494
Mailing address
845 1ST AVE, VERNONIA, OR 97064-1001
(979) 525-9581
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
3097
TX
103K00000X
Behavior Analyst
Primary
ABA-B-10214970
OR
106S00000X
Behavior Technician
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—
Other
Enumeration date
07/20/2018
Last updated
03/09/2023
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