Individual
MCKULLY REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
3550 PARKWOOD BLVD STE 205, FRISCO, TX 75034-1904
(972) 521-9060
Mailing address
3550 PARKWOOD BLVD STE 205, FRISCO, TX 75034-1904
(972) 521-9060
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-62482
TX
106S00000X
Behavior Technician
RBT-20-137465
TX
Other
Enumeration date
07/19/2021
Last updated
11/09/2022
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