Individual
MACKENZIE LEE PRILLAMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
3433 BRAMBLETON AVE, ROANOKE, VA 24018-6515
(540) 266-7550
Mailing address
3433 BRAMBLETON AVE, ROANOKE, VA 24018-6515
(540) 266-7550
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB528480
VA
Other
Enumeration date
06/04/2021
Last updated
06/04/2021
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