Individual
MACKENZIE GEISEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED, BCBA
Contact information
Practice address
41521 W 11 MILE RD, NOVI, MI 48375-1803
(248) 299-0030
Mailing address
12660 LINDY ANNE CT NE, CEDAR SPRINGS, MI 49319-8394
(989) 928-8446
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-41034
MI
106S00000X
Behavior Technician
—
—
Other
Enumeration date
11/16/2017
Last updated
11/18/2021
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