Individual
MACKENZIE RILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
716 EAST BLVD, CHARLOTTE, NC 28203-5114
(919) 375-0475
Mailing address
2520 SOUTH BLVD APT 241, CHARLOTTE, NC 28203-6644
(678) 956-0655
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-70977
—
Other
Enumeration date
09/14/2021
Last updated
03/29/2024
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