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Individual

MAKAYLA JANE SHIELDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RBT

Contact information

Practice address
212 S LINCOLN ST STE A, LOWELL, AR 72745-9722
(479) 770-0744
(479) 770-0176
Mailing address
P.O. DRAWER 2109, RUSSELLVILLE, AR 72811-2109
(479) 967-2322
(479) 967-2876

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
05/25/2023
Last updated
05/25/2023
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