Individual
COURTNEY MACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2891 TURNER CT APT B, HOLLOMAN AIR FORCE BASE, NM 88330-7616
(707) 372-2137
Mailing address
2891 TURNER CT APT B, HOLLOMAN AIR FORCE BASE, NM 88330-7616
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/30/2019
Last updated
12/30/2019
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