Individual
MCKENZIE T BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, BCBA
Contact information
Practice address
1300 E BRADFORD PKWY BLDG B, SPRINGFIELD, MO 65804-4264
(417) 761-5000
(417) 761-5011
Mailing address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 761-5000
(417) 761-5011
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2021039670
MO
Other
Enumeration date
10/15/2021
Last updated
06/11/2025
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