Individual
MAKENNA JANE COOLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4005 AMBERGRIS DR APT 213, LUTZ, FL 33559-6956
(920) 492-9553
Mailing address
4005 AMBERGRIS DR APT 213, LUTZ, FL 33559-6956
(920) 492-9553
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
02516142
FL
106S00000X
Behavior Technician
RBT-23-259878
FL
Other
Enumeration date
02/24/2023
Last updated
08/26/2025
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