Individual
MACKENZIE RODGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5814 OLD PASCO RD, WESLEY CHAPEL, FL 33544-4011
(908) 938-1577
Mailing address
6991 HAYTER DR, LAKELAND, FL 33813-4516
(863) 393-5356
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0-23-14821
FL
106S00000X
Behavior Technician
RBT-21-159891
FL
Other
Enumeration date
04/02/2021
Last updated
10/19/2023
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