Individual
MRS. MIKAYLA SHEA EBNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA, MSED
Contact information
Practice address
310 S DELAWARE ST, NIXA, MO 65714-8823
(618) 917-3037
Mailing address
310 S DELAWARE ST, NIXA, MO 65714-8823
(618) 917-3037
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-72001
MO
Other
Enumeration date
12/23/2020
Last updated
03/22/2024
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