Individual
MACKENZIE PERILLOUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
16331 HERITAGE PL STE 101, EAGLE RIVER, AK 99577-7753
(907) 350-8893
Mailing address
9529 NOAK CIR, EAGLE RIVER, AK 99577-8515
(907) 350-8893
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-270340
AK
Other
Enumeration date
04/24/2023
Last updated
04/24/2023
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