Individual
MISS MACKENZIE KATHLEEN THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1555 SE DELAWARE AVE STE O, ANKENY, IA 50021-4011
(515) 261-2402
Mailing address
1555 SE DELAWARE AVE STE O, ANKENY, IA 50021-4011
(515) 261-2402
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
106S00000X
IA
Other
Enumeration date
10/30/2020
Last updated
10/30/2020
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