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Individual

MAKENZIE MARLENE DANIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BCBA LBA

Contact information

Practice address
373 S WILLOW ST STE 266, MANCHESTER, NH 03103-5751
(187) 731-5808
Mailing address
400 CENTERVIEW DR UNIT 114, BRENTWOOD, TN 37027-5489
(973) 224-9660

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-48112
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
758
LBA
TN
Enumeration date
05/09/2021
Last updated
04/09/2022
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