Individual
MCKENZIE TEMPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
1051 TIFFANY S, POLAND, OH 44514-1977
(330) 629-2955
(330) 629-2955
Mailing address
2117 REEVES RD NE, WARREN, OH 44483-4323
(814) 795-9909
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
OH
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32235419
DRIVER LICENSE
PA
Enumeration date
11/17/2021
Last updated
03/23/2025
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